Variables Associated with Recurrence in Breast Cancer Patients -the Shaukat Khanum Memorial Experience


From a cohort of female breast cancer patients registered at the Shaukat Khanum Memorial Cancer Hospital ‍and Research Center, in Lahore, Pakistan, during the time period extending from December 1994 to December ‍2002, 700 subjects who were followed up in time, were selected. Those who presented with benign tumors, carcinoma ‍in situ, or metastases were excluded from the analyses. Age, tumor size, nodal status, menopause, estrogen receptor ‍(ER), and progesterone receptor (PR) status, at the time of presentation, were determined. Tumors were classified ‍according to the TNM classification (American Joint Commission on Cancer (AJCC)-sixth edition), and subsequently, ‍grouped into T1/T2 and T3/T4. Lymph nodes were categorized as N0 (node-negative) and N1, N2, and N3 combined ‍(node-positive). The odds ratio (OR) for developing recurrence in T3/T4 versus T1/T2 was determined to be 2.06 ‍(95% confidence interval (CI) 1.39-3.05, p < 0.001); the OR for node-positive relative to node-negative was found to ‍be 2.54 (95 % CI 1.61-4.0, p < 0.001). Furthermore, the association between the odds of developing recurrence in ‍ER-positive compared to ER-negative was represented by an OR of 0.61, (95 % CI 0.40-0.94 (p=0.02)). These findings ‍are consistent with the observations that ER-positive, node-negative, and T1/T2 lesions have a decreased risk of ‍recurrence. Also, ER-positive patients may have a better response to hormonal treatment than those who are ERnegative. ‍