NODE-NEGATIVE BREAST-CARCINOMA TREATED WITHOUT ADJUVANT SYSTEMIC THERAPY

In this prospective study, 167 consecutive patients with node-negative invasive breast cancer were treated without adjuvant systemic therapy in a community hospital from 1974 through 1984. The median follow-up for living patients was 84 months. Ninety-three percent of patients had disease classified as T1, NO, MO or T2, NO, MO. Overall survival at 5 years was 81% and at 10 years, 66%. Adjusted survival rates, which excluded patients who died without breast cancer, were 91% at 5 years and 83% at 10 years. Relapse-free survival rates were 74% at 5 years and 61% at 10 years. T status, age, menopausal status, histology, estrogen receptor status, nuclear grade, and sinus histiocytosis were evaluated as prognostic indicators. It was difficult for the pathologists to assign a single value for nuclear grade; however, univariate analysis showed a significant difference in outcome between patients with nuclear grade 1 versus nuclear grade 4 lesions. Patient age is important in the decision regarding adjuvant therapy in that patients aged 70 and older are much more likely to die without breast cancer recurrence. By multivariate analysis, tumor size was the only independently significant factor (P < .0125).