Table of Contents
ISRN Oncology
Volume 2013, Article ID 946945, 7 pages
Research Article

Differential Prognostic Indicators for Locoregional Recurrence, Distant Recurrence, and Death of Breast Cancer

1Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
2Department of Nursing, Uttaradit Hospital, Uttaradit 53000, Thailand
3Department of General Surgery, Nakhon Sawan General Hospital, Nakhon Sawan 60000, Thailand
4Department of General Surgery, Uttaradit General Hospital, Uttaradit 53000, Thailand
5Department of General Surgery, Lampang General Hospital, Lampang 52000, Thailand
6Clinical Epidemiology Society, Chiang Mai 50200, Thailand

Received 25 August 2013; Accepted 14 October 2013

Academic Editors: R. L. Aft and G. Gatti

Copyright © 2013 Rungnapa Chairat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To explore prognostic characteristics for locoregional recurrence, distant recurrence, and mortality in patients with breast cancer. Methods. A 5-year retrospective review of patients was conducted in two university affiliated hospitals in the north of Thailand. Prognostic characteristics and clinical outcomes were retrieved from medical registry. Death was verified by the civil database from the Ministry of Interior, direct telephone contact, or by prepaid postcard. Data were analyzed by stratified Cox’s regression proposed by Lunn & McNeil, in which multiple-typed outcomes were analyzed in a single multivariable model. Results. The assembled cohort comprised 829 patients. Under the multivariable analysis, 7 prognostic characteristics were significant prognostic indicators. Positive axillary lymph nodes >3 and presence of lymphovascular invasion (LVI) increased locoregional recurrence, while disease stage 3, positive axillary lymph nodes >3, and radiotherapy increase distant recurrence. Hormonal therapy reduced the distant recurrence. Pathological tumor size >2 cm, disease stage 3, positive axillary lymph nodes >3, and presence of LVI increased, while hormonal therapy and chemotherapy reduced death. Conclusions. Clinical characteristic reflecting tumor invasions increased locoregional recurrence, distant recurrence, or death, while hormonal therapy and chemotherapy reduced such risks. The effect of radiation remained inconclusive but may increase the risk of distant recurrence.