Local recurrence in breast carcinoma patients with T1–2 and 1–3 positive nodes: Indications for radiotherapy

Aims To investigate the relationship between local recurrence (LR) and distant recurrence (DR) and to determine a subgroup of patients who could benefit from radiotherapy among breast carcinoma patients with T1–2 and N1a. Methods Univariate and multivariate Cox regression analyses were carried out in the retrospective data of 326 eligible patients. Results Fourteen (4.3%) patients had LR and 46 (14.1%) patients suffered DR, in their follow-up periods. The multivariate time-dependent Cox model for DR showed that ratio of positive nodes (PN) (p = 0.004; hazard ratio (HR), 1.05; 95% confidence interval (CI), 1.02–1.09) and LR (p = 0.05; HR, dependent on time) were strongly associated with DR. In the multivariate Cox analysis for LR, age (≤35 years vs >35 years; p < 0.0001; HR, 6.8; CI, 2.3–19.9), lymphatic vascular invasion (LVI) (yes vs no; p = 0.03; HR, 3.3; CI, 1.2–9.8), and a ratio of PN (>15% vs ≤15%; p < 0.0001; HR, 13.0; CI, 3.9–42.0) were the most important prognostic factors. Whereas patients with 2 or 3 risk factors were accepted as the high risk group for LR, those with no or 1 risk factor were considered as the low risk group. These groups had a 23% LR rate and a 2.7% LR rate, respectively (p < 0.0001). Conclusions This report confirmed the importance of local recurrence for distant recurrence. Age, ratio of PN and LVI were the most important prognostic factors for LR. The T1–2 and N1a patients who had 2 or 3 risk factors might benefit from radiotherapy.