Biomedical subjects

B G Haffty

Publications and source records attributed to B G Haffty.

92 records · Page 6Linked to original sources

PubMedDate not supplied

Prognostic significance of mammographic detection in a cohort of conservatively treated breast cancer patients.

PURPOSE: This study aimed to evaluate the prognostic significance of nonpalpable mammographically detected breast cancer in a cohort of conservatively treated breast cancer patients. METHODS AND MATERIALS: The records of 953 patients with invasive stage I and II breast cancer treated with conservative surgery and radiation therapy prior to January 1990 were reviewed. Mode of presentation with reference to clinical and mammographic findings was recorded. For statistical analysis, patients were divided into two groups: 748 patients presented with clinically palpable masses with or without mammographic abnormalities (PALP), and 205 presented with nonpalpable mammographically detected tumors (MGDET). RESULTS: Patients in the MGDET group presented with cancers at earlier stages of disease, had tumors of smaller pathological size, were more often hormone-receptor positive, and less frequently required adjuvant systemic therapy. As of December 1995, with a median follow-up of 11.6 years, the MGDET group had a higher 10-year overall survival rate (82% vs 68%) and a superior 10-year distant-metastasis-free rate (87% vs 75%). The ipsilateral breast tumor relapse rate was similar between the PALP and MGDET groups. When broken down by age (< 50 years vs > or = 50 years), the benefits of early detection remained apparent with a statistically significant superior distant-metastasis-free rate in women under age 50 in the MGDET group compared with women under age 50 in the PALP group. In a multivariate analysis, mammographic detection remained an independent prognostic factor for distant-metastasis-free survival. CONCLUSION: Patients presenting with nonpalpable mammographically detected invasive breast cancer have a favorable prognosis compared with their counterparts presenting with clinically palpable masses. Although the issue of lead-time bias cannot be addressed adequately in this retrospective review, the favorable prognosis with respect to disease-free survival and breast conservation is quite evident. The high probability of disease-free survival and breast preservation in these patients should further encourage the widespread using of screening mammography and the increased use of breast-conserving surgery with radiation therapy.

Breast Neoplasms↗

PubMedDate not supplied

Local recurrence in the conservatively treated breast cancer patient: a correlation with age and family history.

BACKGROUND: The purpose of this study was to evaluate the relationships among young age at diagnosis, family history status, and local recurrence in breast cancer patients treated with lumpectomy and radiation therapy. METHODS: Between January 1970 and December 1990, 984 early-stage breast cancer patients were treated with conservative surgery and radiation therapy at Yale-New Haven Hospital. All patient data, including demographics, staging information, treatment, and outcome variables were entered into a computerized database. The current study focused on the relationships between young age, family history, and local relapse. A group of 52 patients who experienced a local recurrence in the conservatively treated breast and 52 matched control patients who had not experienced a local recurrence were asked to participate in a study to determine whether local recurrence was associated with family history. Detailed family history interviews were conducted, and pedigrees were analyzed by a genetic counselor who was blind to the clinical history of the patients. RESULTS: As of September 1997, with a median follow-up of 12.3 years for the 984 patients in the database, the overall actuarial 10-year survival is 73%, and the 10-year distant metastasis-free survival is 78%. Of the 984 patients, 112 have experienced a local relapse in the conservatively treated breast, resulting in a 10-year actuarial breast relapse rate of 15%. The 10-year survival after breast relapse is 69%. Patient age tested as a continuous variable correlated strongly with ipsilateral breast tumor relapse. Using age 40 as a cutpoint, patients aged 40 years or less had a significantly higher local relapse rate than patients older than 40 years (P < 0.001). Although the relationship between local relapse and young age was strong, no association was found between family history and local relapse in the detailed family history study. CONCLUSIONS: Young age at diagnosis was a significant prognostic factor for local relapse. In a detailed family history study using a case-control design, no significant differences in family history status were found between patients who had experienced a local relapse and patients who had not.

Adult↗