OBJECTIVE: This study was designed to determine the effect of age, size of tumor, number of positive axillary nodes and the different adjuvant treatments on the disease-free survival and overall survival of a group of patients with locally advanced invasive ductal carcinoma not treated with neoadjuvant therapy.
METHODS: All breast cancer patients seen by the senior author at St. Luke's Medical Center, Chinese General Hospital and Cardinal Santos Medical Center from January 1980 to October 2000 were reviewed. Of the 415 breast cancer patients seen, 78 locally advanced breast cancer patients who did not undergo neoadjuvant treatment but underwent modified radical mastectomy and subsequent adjuvant therapy were included in this study.
RESULTS: The mean age of the patients was 49 years and the mean tumor size was 5.4 centimeters. The median follow-up was 35 months (range=3-180 months). There were 47 recurrences (11 percent) and 24 (5 percent) deaths and the average time to recurrence was 23 months. There were no significant linear correlations between age, tumor size and number of positive lymph nodes on the disease-free survival and overall survival (p0.05). Likewise, there was no significant difference on the disease-free survival between the patients treated by anyone of the four mentioned adjuvant treatments (p0.05). However, those who received chemotherapy and hormonal therapy had a significantly longer overall survival compared to those who received either one of the three other adjuvant treatments (p0.05). Postoperative radiotherapy did not appear to offer a significantly longer disease-free and overall survival.
CONCLUSION: In locally advanced breast cancer patients who did not receive neoadjuvant treatment, increasing age, increasing size of the breast tumor and increasing number of positive axillary nodes did not correlate significantly to shorter disease free survival and overall survival. Postoperative chemotherapy and hormonal therapy combination without radiotherapy showed a trend of longer overall survival in selected patients.