Indicators of loco-regional recurrence in breast cancer

Aim: The aim of the investigation was to contribute to the identification of patients who have increased or decreased risk of loco-regional recurrence. Methods: Six hundred and twenty-nine consecutive patients with primary breast cancer diagnosed between 1988 and 1990 were studied. Two-thirds of the patients underwent mastectomy. Radiotherapy was administered if patients were node positive or breast conserved. The Nottingham histological grading protocol was used and presence of lymphovascular invasion was assessed. Investigated parameters were: age, size, grade, steroid receptor content, surgical radicality, vascular invasion and nodal status. Statistically significant risk factors for loco-regional recurrence using univariate or Cox proportional hazard analysis were grade and lymphovascular invasion. Results: Women with grade 1-2, node-negative tumours without vascular invasion had a very low loco-regional recurrence rate-3.1%. Seventeen percent of patients with grade 3 tumours and vessel invasion had loco-regional recurrence. Conclusions: Our findings, and those of others, indicate that the use of adjuvant radiotherapy should be influenced to a greater extent by grade and lymphovascular invasion. (C) 2000 Harcourt Publishers Ltd.