Identifying accessible prognostic factors for breast cancer relapse: a case-study on 405 histologically confirmed node-negative patients.
BACKGROUND
Histologically, node-negative breast cancer generally have a good prognosis. However, 10 to 30% of the cases present local relapses or metastasis. This group of people has high chances of remission if detected early. The aim of this study is to identify financial affordability for developing countries to adjust treatment.


METHODS
We selected 405 patients with histologically confirmed node-negative breast cancer in our institution between January 2001 and December 2003. Patients with metastasis were excluded. The statistical analysis was conducted using SPSS ver. 18 (SPSS, Inc., Chicago, Illinois).


RESULTS
The medial age was 51 years old. The medial tumor size was 35.4 mm. Clinically, 67.2% of the patients were staged cT2 and 63.2%, cN1i. Breast conservation was achieved in 41% of cases. In the histologic examination, the medial size was 30 mm. Grade III tumors were found in 50.1% of patients and positive hormonal receptors in 53.4%. The mean number of lymph nodes was 14. Eight patients had neoadjuvant chemotherapy. Adjuvant locoregional radiation and adjuvant chemotherapy were prescribed respectively in 70.6 and 64.4% of cases. 59.7% had adjuvant hormonal therapy. The follow-up showed 17.7% cases of relapse either locally or in a metastatic way in a mean time of 57.4 months. The disease-free survival at 5 years was 82.1%, and the overall survival for the same period was 91.5%. The histologic tumor size and the grade and number of lymph node dissected were shown to be influencing the disease-free survival. Radiation therapy and hormone therapy showed improved disease-free survival and overall survival.


CONCLUSION
Our study found interesting results that may help personalize the treatment especially for patient living in underdeveloped countries, but further studies are needed to evaluate those and more accessible prognostic factors for a more accessible healthcare.
['Zemni|Ines|I|', 'Ghalleb|Montassar|M|', 'Jbir|Ichraf|I|', 'Slimane|Maher|M|', 'Ben Hassouna|Jamel|J|', 'Ben Dhieb|Tarek|T|', 'Bouzaiene|Hatem|H|', 'Rahal|Khaled|K|']
D018931:Antineoplastic Agents, Hormonal D001940:Breast D001943:Breast Neoplasms D017024:Chemotherapy, Adjuvant D018572:Disease-Free Survival D005260:Female D005500:Follow-Up Studies D017048:Health Care Costs D006801:Humans D008198:Lymph Nodes D008207:Lymphatic Metastasis D008408:Mastectomy D008875:Middle Aged D020360:Neoadjuvant Therapy D060787:Neoplasm Grading D009364:Neoplasm Recurrence, Local D009367:Neoplasm Staging D057285:Precision Medicine D011379:Prognosis D018714:Radiotherapy, Adjuvant D012189:Retrospective Studies D015996:Survival Rate
Breast cancer Early stage Node negative Prognoses