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Factors predictive of mortality in a cohort of women surgically treated for breast cancer from 1997 to 2014
Author(s) -
GarcíaFernández Antonio,
Barco Israel,
Fraile Manel,
Lain José M.,
Carmona Ana,
Gonzalez Sonia,
Pessarrodona Antoni,
Giménez Nuria,
GarcíaFont Marc
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.02.014
Subject(s) - medicine , breast cancer , lymphovascular invasion , oncology , stage (stratigraphy) , multivariate analysis , cancer , prospective cohort study , lymph node , gynecology , metastasis , paleontology , biology
Objective To determine whether previously reported factors predictive of breast cancer mortality are effectively linked with mortality, particularly breast‐cancer‐specific mortality. Methods In a prospective study, clinical, surgical, and follow‐up data were assessed for consecutive patients with breast cancer who underwent surgery between 1997 and 2014 at two centers in Barcelona, Spain. Predictors of mortality were assessed by multivariate analysis. Results Overall, 2134 patients were treated for 2206 breast tumors. Overall mortality was 15.0% (n=319), and breast‐cancer‐specific mortality was 9.0% (n=191). On multivariate analysis, the most significant factors associated with breast‐cancer‐specific mortality were clinical stage, inmunohistochemical profile, locoregional relapse, and lymphovascular invasion (all P <0.001). Age at onset, participation in the mass‐screening program, histologic grade, and multicentricity were not significant. Patients with three or more positive axillary nodes sustained a specific mortality significantly higher than did node‐negative patients or those with fewer than three positive nodes. Conclusion Factors predictive of breast cancer mortality were clinical stage, locoregional relapse, molecular classification, lymphovascular invasion, and neoadjuvant chemotherapy. As a single factor, nodal disease becomes relevant only when three or more lymph nodes are involved.