[Twenty years long experience in the breast conserving treatment of women with preinvasive breast cancer. Evaluation of long term results and analysis of prognostic factors.] / Dwadziescia lat doswiadczen w leczeniu oszczedzajacym u kobiet chorych na przedinwazyjnego raka gruczolu piersiowego. Ocena odleglych wyników i analiza czynników rokowniczych.

ABSTRACT

AIM: The aim of the study was to analyze long term results and prognostic factors in women with preinvasive breast cancer (DCIS - ductal carcinoma in situ) who underwent breast conserving surgery with subsequent radiotherapy. MATERIALS AND METHODS: A total number of 106 patients was analyzed aged 29-78 years; mean age was 54,3 years and median 55 years. In 78 (73,5%) patients the tumor was diagnosed incidentally on mammography or ultrasound scan, 28 (26,5%) had palpable lesion. 57 patients had the tumor in the left breast and 49 in the right one. Most often the tumor was localized in external quadrants, namely in 56 (52,8%) patients. All patients had breast conserving surgery and then adjuvant radiotherapy of the breast in typical doses. For evaluation of survival we used the Kaplan-Meier test and for evaluation of cumulated loco-regional recurrence we have applied the method of competing risks. RESULTS: At present 101 patients are still alive, 85 have no relapse. 15 patients had local recurrence and 8 had another cancer. Five patients died during follow-up period. Overall 15-years survival in analyzed group was 88% and disease free survival was 74%. Of all prognostic factors only the value of Van Nuys index was relevant. Patients who had the index value less than 7 had significantly worse prognosis than patients with value 7 or more (p=0,043). CONCLUSIONS: At present 101 patients are still alive, 85 have no relapse. 15 patients had local recurrence and 8 had another cancer. Five patients died during follow-up period. Overall 15-years survival in analyzed group was 88% and disease free survival was 74%. Of all prognostic factors only the value of Van Nuys index was relevant. Patients who had the index value less than 7 had significantly worse prognosis than patients with value 7 or more (p=0,043).