658 Prognostic factors in breast cancer less than 3 cm without histologic lymph node involvement

Axillary lymph node involvement is thè most important prognostic indicator for breast cancer. Nevertheless, nearly 25% of patients with histologic negative lymph node will develop distant metastasis. Between 1974 and 1985, 201 patients with breast cancer, less than 3 cm, without axillary lymph node involvement were followed in thè “Centre René Gauducheau”. Thè aim of our study was to analyse on this population which clinical and histological parameters were correlated with local recurrence or distant metastasis. We realise a multivariate analysis using thè Cox model. We showed that hormonal status, age and multifocality were significantly and independently correlated with locai recurrences, and that pathologic grading (SBR), tumor localization in thè breast were prognostic factors of distant metastasis.Finally we found that thè nuclear grading (MSBR) 4 or 5 permit to determine in thè population SBR II, a sub-group of women associated with a high risk of metastatic evolution, in which it will be probably necessary to discuss systemic adjuvant therapy to prevent distant metastasis.