| Background Breast cancer is still one of the most common malignant tumor threatening to female health in the world. The incidence of breast cancer has become the first place among the female malignances in the middle and largest cities in China, according to recent screening. In the Europen countries, breast cancer is the most commonly diagnosed cancer in women, the second leading cause of cancer death. Although the treatment of this disease has been hundred years, the biological behavour and the nature history of breast cancer has not been fully elucidated. From Halsted era (Classic radical mastectomy) to Fisher era (Breast-conserving surgery), in recent years, most surgeons accepted Fisher's hypothesis that "most, if not all, patients with solid tumors have disseminated disease by the time a clinical diagnosis is established ", such an understanding provide a new theory for investigating new therapies. In past hundred years, physicians have been marking progress in the treatment of patients with this disease. Randomized Controlled trials indicate that surgery plus adjuvant systemic therapy, and adjuvant therapy and or hormonal therapy can reduce the risk for death caused by breast cancer and improve the survival rate.Materials and MethodsBetween January 1990 and December 1999, a total of 730 patients with breast cancer were treated with surgery at First Hospital of Jilin University. Characteristics of the entire patients population are as follow: seven hundred twenty-one patients (98.8%) are female, 9 (1.2%) are male. The median age at diagnosis was 46.8 (range18-82) years. The peak age incidence was 41-50 years, 67.9% of patients were 50 years or younger. A distinct premenopausal peak was observed. 52.6% of tumors occurred in the left breast, 46.4% in the right, bilateral in 1%. Patients were clinically and pathologically staged in accordance with UICC, 68 (9.3%)patients were stage I, 524 (71.8%)were stage II, 123 (16.8%) patients were stage III and 15 (2.1%) were stage Ⅳ. 402 (55.1%) patients had no axillary lymph node metastases, 210 (28.8%)patients had 1-3 positive lymph nodes, 81 (11.1%) had 4-7 positive lymph nodes. 37 (5.1%) had more than 7 positive lymph nodes. Two hundred fifty-six (35.1%) cancers were infiltrative duct carcinoma, 176 (24.1%) were simple carcinoma, 115 (15.8%) were infiltrative lobular carcinoma, 64(8.5%) were the medullary carcinoma, 49 (6.7%) were the scirrhous carcinoma, 34 (4.7%) were the mucus adeno- carcinoma. One hundred forty-two (19.5%) patients had ER positive, 56 (7.7%) had ER negative, and 532 (72.8%) had unknown. Between January 1990 and December 1994, one hundred six (41.4%) patients underwent radical mastectomy, 150 (58.59%) underwent modified radical mastectomy, Between January 1995 and December 1999, Thirty-three (7.76%) patients underwent radical mastectomy, 428 (92.24%) underwent modified radical mastectomy. One hundred fourty-nine (20.4%) patients had no postoperative therapy, 93 (12.7%) patients, 13 (1.8%), and 16 (2.2%) received post-operative chemotherapy, radiotherapy and hormonal therapy alone, respectively. One hundred seventy-five (24.0%) patients received postoperative chemotherapy plus radiotherapy, 51(7.0%) patients and 6(0.8%) patients received chemotherapy plus hormonal therapy and radiotherapy plus hormonal therapy, respectively. One hundred sixty–three (22.3%) patients received postoperative chemotherapy, radiotherapy plus hormonal therapy. 64 (8.8%) patients had unknown; Follow-up data were obtained to March 26, 2004, Follow-up duration was calculated from the date of surgery to the date of last follow-up, or death. The median follow-up, based on censoring distribution, was 8.42years. Four hundred and sixty-three (63.4%) patients are alive, 229 (31.4%) patients were died, and 38 (5.2%) patients were lost to follow-up. One handred and fifty-nine (22.08%) patients had local or/and regional recurrences, 512 (71.11%) patients had no evidence of breast recurrence, 49 (6.81%) patients had unknown. Survival curves were generated... |
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