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J. P. Crowe, Jr, MD; N. H. Gordon, PhD; A. R. Antunez, MD; R. R. Shenk, MD; C. A. Hubay, MD; J. M. Shuck, MD, DSc

Arch Surg. 1991;126(4):429-432.

Abstract
• Local-regional recurrence patterns were investigated in 1392 patients with breast cancer. Primary treatment for all patients included a mastectomy. Nine hundred seventeen patients had negative nodes and did not receive systemic therapy. Four hundred seventy-five patients had node metastases and were randomized to receive different combinations of chemoendocrine therapy. Follow-up ranged between 5 and 16 years. Two hundred thirty (25.8%) node-negative patients have had recurrences, with the initial recurrence being local-regional in 9.2%. Two hundred forty-two (50.9%) node-positive patients have had recurrences, with the initial recurrence being local-regional in 17.1%. Larger tumors and more extensive node involvement were associated with more first local-regional recurrences. The relative percent of first local-regional recurrence among patients in whom cancer recurred was similar for node-negative and node-positive patients (35.4% and 33.5%, respectively). In 63.6% of patients in whom cancer recurred, first local-regional recurrence were distant. Larger tumors, more extensive node involvement, and a shorter disease-free interval after mastectomy were associated with more rapid appearance of distant recurrence among these patients.

(Arch Surg. 1991;126:429-432)

Author Affiliations
Participating Investigators

From the Departments of Surgery (Drs Crowe, Gordon, Shenk, Hubay, and Shuck) and Epidemiology and Biostatistics (Dr Gordon), Ireland Cancer Center (Dr Gordon), and Department of Radiation Therapy (Dr Antunez), Case Western Reserve University and University Hospitals of Cleveland, Ohio.

Footnotes
Accepted for publication November 17, 1990.

Read before the 43rd Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, May 20, 1990, and the American Society of Clinical Oncology 1990 Meeting, Washington, DC, May 22, 1990.

Reprint requests to the Department of Surgery, University Hospitals of Cleveland, 2074 Abington Rd, Cleveland, OH 44106 (Dr Crowe).

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