Identifying the risk factors of local recurrence of early-stage breast cancer after surgery and adjuvant treatment

Abstract EN

Background : Local recurrence of breast cancer after treatment remains a major challenge that affects survival and quality of life.

Identifying the risk factors for locoregional recurrence (LRR) may change our strategies in the treatment of those patients to let them enjoy long survival.

Aim of the Study : To identify the risk factors associated with high rate of local recurrence of early breast cancer and its impaction on time of recurrence.

Materials and Methods: In this retrospective study, we evaluated 225 patients with early breast cancer (T1–2, N0–1) with a mean age of 46.178 years and a median of 45 years, who treated by surgery and adjuvant treatment (chemotherapy and/or hormonal therapy) without radiotherapy in Babylon Oncology Center from 2012 to 2014 and followed for next 5 years.

We collected data to identify the risk factors ; we used files from archive and follow-up program in this center.

We used SPSS version 23 in our calculation; P ≤ 0.05 was considered statistically significant.

Results : From a total of 225 patients, the mean age was 46.178 years and the median was 45 years; we found that 31 (13.8%) patients developed local recurrence after surgery.

The median time for follow-up was 40.2 months, and the median time to recurrence was 30 months.

From 31 recurred patients, 58.1% were recurred after 2 years and 41.9% recurred within 2 years and less after surgery.

In univariate analyses, tumor size more than 20 mm, lymph nodes (LNs) <10 removed by surgery, positive (1–3) LNs, high-grade tumor, presence of lymphovascular invasion, extracapsular extension, and estrogen receptor (ER) negative appeared significant for local recurrence.

In multivariate analyses, all significant factors did not change except number of LNs removed and ER negative.

No single factor appears significant for early recurrence (2 years and less after surgery).

Conclusion: Our study showed many factors can affect locoregional recurrence after initial treatment with surgery and chemotherapy with (58.1%) of cases recur after 2 years of surgery, so we recommend 1) offering a post mastectomy radiotherapy (PMRT) for those patients with significant clinical and pathological risk factors.

2) establish a close follow up program to diagnose early LRR to deal with those patient early in order to prevent more serious event that affect quality of life and patient survival.