Survival Analysis and Its Prognostic Factors after Distant Relapse in Breast Cancer Patients

Yoon, Ho Sung; Hong, Seong hee; Kang, Hee Joon; Xu, Xuejun; Ahn, Sei Hyun

Abstract

PURPOSE
Little attention has been paid to predictive the factors for recurrence and survival after relapse in patients with breast cancer in Korea. The purpose of this study was to identify the survival and potential prognostic factors associated with survival from the time of a distant relapse. METHODS: Between 1989 and 2000, 2355 patients were treated by surgery for breast cancer at the Breast Clinic of the Asan Medical Center. We retrospectively analyzed 247 women who developed a distant relapse among that. RESULTS: The median follow-up duration from the first distant relapse was 10.5 months (0.5-101 months) and the median age at the time of relapse was 46.8 years, retrospectively. The median survival was 19.2 months with a 41.5% and 19.5%, two and five year overall survivals. The dominant sites for the spread were bone (32.0%), lung (29.3%), soft tissue (20.0%) and other visceral organs (18.7%). The median survivals along the site of the relapse were as follows: bone, 26.6; soft tissue, 19.5; lung, 15.8; and other visceral organs, 9.0 months. The location of recurrence, number of metastatic site (both visceral and multiple), the axillary lymph node status (above 4), and operation methods (breast conserving operation) were significantly associated with shorter survivals from the first distant relapse. Conversely, the estrogen receptor status, adjuvant chemotherapy and disease free interval, all failed to reach statistical significance. CONCLUSION: We confirmed that our results for survival of the distant relapsed patients were similar, when comparing to those of Western countries. In this study, the site of the initial recurrence and the axillary lymph node status were important factors for predicting survival after distant recurrence and should help in designing new therapeutic strategies for this group of patients.