Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer

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Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer. / Ewers, Sven-Börje; Attewell, Robyn; Baldetorp, Bo; Borg, Åke; Fernö, Mårten; Långström-Einarsson, Eva; Ryden, Stefan; Killander, Dick.

In: Acta Oncologica, Vol. 31, No. 7, 1992, p. 733-740.

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Ewers, Sven-Börje ; Attewell, Robyn ; Baldetorp, Bo ; Borg, Åke ; Fernö, Mårten ; Långström-Einarsson, Eva ; Ryden, Stefan ; Killander, Dick. / Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer. In: Acta Oncologica. 1992 ; Vol. 31, No. 7. pp. 733-740.

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TY - JOUR

T1 - Flow cytometry DNA analysis and prediction of loco-regional recurrences after mastectomy in breast cancer

AU - Ewers, Sven-Börje

AU - Attewell, Robyn

AU - Baldetorp, Bo

AU - Borg, Åke

AU - Fernö, Mårten

AU - Långström-Einarsson, Eva

AU - Ryden, Stefan

AU - Killander, Dick

PY - 1992

Y1 - 1992

N2 - The study concerns whether DNA flow cytometry and estrogen receptor analysis might help predict which breast cancer patients, particularly node-positive ones, were at the greatest risk of developing loco-regional recurrence (LRR). Such patients would best benefit from postoperative radiotherapy following modified radical mastectomy and axillary lymph node dissection. After this type of surgery, 506 patients were followed up for a median time of nearly 5 years. Among the 235 patients given postoperative radiotherapy, the loco-regional control rate was 100% in N0 cases (n = 93), 94% in cases with 1-3 positive nodes (n = 90), 93% in cases with 4-9 positive nodes (n = 43), and 67% in cases with 10 or more positive nodes (n = 9). Among the 271 non-irradiated patients, the corresponding figures for loco-regional control were 91% in N0 cases (n = 141), 71% in cases with 1-3 positive nodes (n = 84), 65% in cases with 4-9 positive nodes (n = 31), and 67% in cases with 10 or more positive nodes (n = 15). Ploidy status, level of S-phase fraction, estrogen receptor content, and primary tumor size did not, in the present material, yield significant additional information with regard to the risk of LRR in the different nodal subgroups, a finding confirmed in multivariate analysis where the only significant predictor of LRR was the number of positive nodes (p = 0.01). Adjuvant tamoxifen treatment could not replace postoperative radiotherapy for achieving loco-regional tumor control, the overall rate of which was 81% among patients treated with tamoxifen only (n = 117), as compared with 98% among those also treated with radiotherapy (n = 54) (p = 0.003).

AB - The study concerns whether DNA flow cytometry and estrogen receptor analysis might help predict which breast cancer patients, particularly node-positive ones, were at the greatest risk of developing loco-regional recurrence (LRR). Such patients would best benefit from postoperative radiotherapy following modified radical mastectomy and axillary lymph node dissection. After this type of surgery, 506 patients were followed up for a median time of nearly 5 years. Among the 235 patients given postoperative radiotherapy, the loco-regional control rate was 100% in N0 cases (n = 93), 94% in cases with 1-3 positive nodes (n = 90), 93% in cases with 4-9 positive nodes (n = 43), and 67% in cases with 10 or more positive nodes (n = 9). Among the 271 non-irradiated patients, the corresponding figures for loco-regional control were 91% in N0 cases (n = 141), 71% in cases with 1-3 positive nodes (n = 84), 65% in cases with 4-9 positive nodes (n = 31), and 67% in cases with 10 or more positive nodes (n = 15). Ploidy status, level of S-phase fraction, estrogen receptor content, and primary tumor size did not, in the present material, yield significant additional information with regard to the risk of LRR in the different nodal subgroups, a finding confirmed in multivariate analysis where the only significant predictor of LRR was the number of positive nodes (p = 0.01). Adjuvant tamoxifen treatment could not replace postoperative radiotherapy for achieving loco-regional tumor control, the overall rate of which was 81% among patients treated with tamoxifen only (n = 117), as compared with 98% among those also treated with radiotherapy (n = 54) (p = 0.003).

U2 - 10.3109/02841869209083862

DO - 10.3109/02841869209083862

M3 - Article

VL - 31

SP - 733

EP - 740

JO - Acta Oncologica

JF - Acta Oncologica

SN - 1651-226X

IS - 7

ER -