Samuel D. Ang, Roel S. Tolentino , Benito Tan, Malen M. Gellido,
Ferdinand Malubay Related Institution
Chinese General Hospital and Medical Center Publication Information
Publication Sub Type
Journal Article, Original
Philippine Journal of Surgical Specialties
OBJECTIVES: The objectives of this study were to determine the clinicopathologic profile of stage I and stage II Filipino breast cancer patients who underwent mastectomy with level I-III axillary lymph node dissection, and to compare the recurrence rate, disease-free survival and the overall survival by stage of these patients.
METHODS: All patients in the breast cancer database system of the Division of Surgical Oncology of St. Luke's Medical Center were reviewed. All patients were surgically treated by the senior author starting June 1985 and were followed up until January 2005.
RESULTS: There were 152 patients (46 stage I and 106 stage II patients) included in this study. Mean age was 51 years. All underwent mastectomy with level I-III axillary lymph node dissection. The mean size of the tumors was 2.7 cm. Ninety-six percent of the tumors were invasive ductal carcinoma. With a median follow-up of 78 months, the recurrence rate of the 152 patients was 20 percent, while the five-year disease-free survival was 87 percent, and a five-year overall survival of 91 percent. The recurrence rates for stage I and II patients were 17 and 22 percent, respectively (p=0.6400). By log rank test there was no significant difference in the disease-free survival and overall survival between stage I and stage II breast cancer patients (p=0.4638 and p=0.3958, respectively). CONCLUSION: The clinicopathologic characteristics of stage I and II breast cancer patients were presented. Performing a complete level I-III axillary lymph node dissection together with mastectomy in stage I-II breast cancer patients showed relatively high 5-year overall and disease-free survival rates for both stages. References
1. Laudico, AV , Esteban, DB , Redaniel, MM , Mapua, CA , Reyes, LM . "2005 Philipine cancer facts and estimate"
Philippine Cancer Society, Inc. , 8-9, 2004
2. Henderson, IC , Patek, AJ . "The relationship between prognostic and predictive factors in the management of breast cancer"
Breast Cancer Res Treat
52(1-3): 261-288, 1998. Retrieved from:
3. Greene, FL , Page, DL , Fleming , ID , Fritz, AG , et al., . Cancer staging manual staging forms sixth edition, 2002. American Joint Committee on Cancer Springer-Verlag, 2002. 25-1-25-4.
4. Mersin, H , Yoldorom, E , Bulut, H , Berberoglu, U . "The prognostic significance of total lymph node number in patients with axillary lymph node-negative breast cancer"
29(2): 132-138, 2003. Retrieved from:
6. Shukla, HS , Melhuish, J , Mansel, RE , Hughes, LE . "Does local therapy affect survival rates in breast cancer? "
Ann Surg Oncol
1(6(5)): 455-460, 1999. Retrieved from:
7. Wright, FC , Walker, J , Law, CHL , McCready, DR . "Outcomes after localized axillary node recurrence in breast cancer"
Ann Surg Oncol
10(9): 1054-1058, 2003. Retrieved from:
9. Cooper, JS , Henson, DE , et al., . In: Cancer Staging Manual 5th ed. Philadelphia: Lippincott - Raven, 1997. 171-178.
10. Tolentino, RS , Ang, SD , Cajucom, CC , Eufemio, GG , Talla, VS , Lo, RW . "The prognostic significance of the S-phase fraction and DNA ploidy in node-negative estrogen receptor-positive breast cancer"
Philip J Surg Spec 53(1): 25-30, 1998
12. Kute, TE , Russell, GB , Zbieranski, N , et al., . "Prognostic markers in node negative breast cancer: a prospective study"
Cytometry B Clin Cytom
59B(1): 24-31, 2004. Retrieved from:
13. Michels, JJ , Marnay, J , Plancoulaine, B , Chasle, J . "Flow cytometry in primary breast carcinomas: prognostic impact of S-phase fraction according to different analysis patterns"
Cytometry B Clin Cytom
59B(1): 32-39, 2004. Retrieved from:
14. Krongvist, P , Kuopio, T , Nykanen, M , Helenius, H , Anttinen, J , Klemi, P . "Predicting aggressive outcome in T1N0M0 breast cancer"
Br J Cancer
91(2): 277-281, 2004. Retrieved from:
15. Tolentino, RS , Ang, SD . "Evaluation of prognostic factors in axillary node-negative estrogen receptor-positive breast cancer: Introduction of a new prognostic index"
Phil J Oncol 5(2): 83-89, 2002
19. Goldhirsch, A , Wood, WC , Gelber, RD , Coates, AS , Thurlimann, B , Senn, HJ . "Meeting highlights: updated international expert consensus on the primary therapy of early breast cancer"
J Clin Oncol 1521(17): 3357-3365, 2003
20. Crivellari, D , Price, K , Gelber, RD , et al., . "Adjuvant endocrine therapy compared with no systematic therapy for elderly women with early breast cancer: 21-year results of International breast cancer study group trial IV"
J Clin Oncol
1521(24): 4517-4523, 2003. Retrieved from:
21. Kiel, KD . "Management of TI a breast cancer"
Clin Breast Cancer 5(1): 43-51, 2004
22. Winer, EP , Hudis, C , Burstein, HJ . "American Society of Clinical Oncology technology assessment on the use of aromatase inhibitors as adjuvant therapy for women with hormone receptor positive breast cancer: status report 2002"
J Clin Oncol 20(15): 3317-3327, 2002
23. "Early breast cancer trialist collaborative group. Tamoxifen for early breast cancer: an overview of the randomised trials"
351(9114): 1451-1467, 1998. Retrieved from:
24. Bryan, J , Fisher, B , Dignam, J . "Duration of adjuvant tamoxifen therapy. In: Journal of the National Cancer Institute monographs. No.30. Bethesda, MD."
National Cancer Institute , 56-61, 2001
25. Fisher, B , Dignam, J , Bryant, J , Wolmark, N . "Five versus more than five years of tamoxifen for lymph node-negative breast cancer: updated findings from the National Surgical Adjuvant Breast and Bowel Project B-14 randomized trial"
J Natl Cancer Inst
93, 684-690, 2001. Retrieved from:
26. Stewart, HJ , Prescott, RJ , Forrest, AP M. "Scottish adjuvant tamoxifen trial: a randomized study updated to 15 years"
J Ntl Cancer Inst 93, 456-462, 2001
27. Tormey, DC , Gray, R , Falkson, HC . "Postchemotherapy adjuvant tamoxifen therapy beyond five years in patients with lymph node positive breast cancer"
J Natl Cancer Inst
88, 1828-1833, 1996. Retrieved from:
30. Tolentino, RS , Cajucom, CC . "Tamoxifen in the treatment of patients with axillary node-negative estrogen receptor-positive breast cancer"
Philip J Surg 53(2): 49-53, 1998
33. Golshan, M , Martin, WJ , Dowlatshani, K . "Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection"
The American Surgeon
69(3): 209-212, 2003. Retrieved from: