Rowell identified risk factors for locoregional recurrence (LRR) in women with node-negative breast cancer. These patients may benefit from more aggressive management. The author is from Kent Oncology Centre, Maidstone Hospital, Kent, UK
Parameters affecting locoregional recurrence:
(1) lymphovascular invasion
(2) histologic grade
(3) primary tumor size in cm
(4) resection margin
(5) age and/or menopausal status
Parameter
Finding
Points
lymphovascular invasion
absent
0
present
1
histologic grade
Grade I or II
0
Grade III (poorly differentiated)
1
primary tumor size
<= 2 cm
0
> 2 cm
1
resection margin
not close
0
close or positive
1
age and/or menopausal status
postmenopausal and age >= 50
0
premenopausal or age < 50
1
number of risk factors for LRR =
= SUM(points for all 5 factors)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 5
• Radiotherapy should be considered for a patient with >= 2 risk factors since this can significantly reduce the risk of locoregional recurrence and may improve survival.
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