Are prognostic factors for local control of breast cancer treated by primary radiotherapy significant for XXXX treated by mastectomy?

@entity1 @entity3821 @entity66 @entity5 @entity75 @entity189 @entity204
Recent follow-up studies of @entity1 with @entity189 treated with breast-conserving primary radiotherapy identified a triad of pathologic features significantly associated with local treatment failure. These unfavorable characteristics of the @entity5 were: poor or undifferentiated nuclear grade; @entity3821 within the @entity5 mass; and @entity3821 in breast tissue outside the perimeter of the @entity75 . The current study was undertaken to assess the impact of these same factors on the prognosis of 573 consecutively treated @entity1 , with @entity189 5 cm or less in diameter, and who underwent mastectomy. Histologic sections of all @entity5 were reviewed, and the lesions were classified according to the distribution of @entity3821 present: only within the @entity5 (IN, 247 cases, 43%), only outside the @entity5 (OUT, 25 cases, 4%), within the outside (IN-OUT, 158 cases, 28%), or not seen (IFDC, 143 cases, 25%). The median follow-up period for the entire series was 56 months. Ninety-five (17%) @entity1 were @entity66 (median time to @entity204 , 36 months). Variables that proved to be statistically significant for overall survival were nodal status (P less than 0.001), nuclear grade (P less than 0.03), and histologic grade (P less than 0.007). Nodal status (P less than 0.001), histologic grade (P less than 0.001), and @entity5 size (P = 0.01) were significant predictors of disease-free survival. The pattern of @entity3821 , when present, was not predictive of the risk for recurrence or survival in @entity1 treated by mastectomy. These findings provide a rationale for additional surgical treatment for @entity1 whose @entity5 have features more likely to be associated with local failure following primary radiotherapy. To permit more detailed pathologic examination of the @entity75 , the initial excision should be carried out separately from the treatment when limited resection and radiation are to be considered as a treatment option.
