Long-term relapses in breast cancer patients.
The authors examined 100 cases of long-term relapses of breast cancer arising more than 5 years after radical mastectomy and 100 cases of early relapses (within 3 years). Precautional radiotherapy or chemotherapy had not been performed during these intervals. Histologic type did not appear important. Long-term relapses were relatively less frequent than early relapses at the level of the locoregional lymph nodes (P less than 0.01). Other investigations were directed to the eventual importance of hormones on the incidence of long-term relapses. Since many of the cases were not recent and therefore no data were available as regards hormone receptors, it was impossible to base the study on the latter. The incidence of long-term relapses was considerably lower in postmenopausal than in premenopausal patients and lower than the incidence observed for early relapses (P less than 0.04). This finding could be attributed to a hormonal effect. Therapeutic oophorectomy determines relatively better results in cases with long-term relapses, but their survival does not appear to be significantly better than that of cases with early relapses. Among the patients with long-term relapses, the N - cases at the time of mastectomy were relatively more numerous than observed among cases with early relapses (P less than 0.04). This finding, which also explains the relatively minor frequency of long-term relapses in locoregional lymph nodes, reduces the prognostic importance of the histologic status of axillary lymph nodes, as is well known for patients with hormonal receptors.