Abstract
BackgroundA number of patients treated conservatively for breast cancer will develop loco-regional and distant recurrences. Our aim was to determine how their occurrence may be linked to the evolution of the disease.MethodsWe analyzed 238 women treated by conservative breast surgery and breast irradiation in a single institution. We evaluated the prognostic factors associated with loco-regional and distant recurrences and the prognostic value of local and regional recurrences on systemic progression.ResultsAfter a median follow-up of 5 year (range 1–10), 16 (6.72 %) patients in the breast conservative surgery (BCS) groups had loco-regional recurrence. For distant recurrence, 10 (4.2 %) patients had experienced distant recurrence. Lympho-vascular invasion (HR 2.55; 95 % CI, 076 to 8.49) and an extensive intraductal component (HR, 2.22; 95 % CI, 0.69 to 7.15) and nodal status are risk factors for loco-regional recurrence (LRR) after breast conservative therapy (BCT). Tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years) are correlated with higher distant recurrence rates after BCT.ConclusionsRisk factors for LRR after BCS include lympho-vascular invasion, extensive inraductal component, and high nodal status, where as risk factors for distant recurrence include tumor size, nodal status, high histologic grade, and breast cancer diagnosed at a young age (≤35 years).
Highlights
A number of patients treated conservatively for breast cancer will develop loco-regional and distant recurrences
There was a shift from the orthodox treatment applying modified radical mastectomy (MRM) to breast conservative surgery (BCS) with radiotherapy [1,2,3,4]; BCS became the standard treatment for patients with early breast cancer
The study revealed that the presence of an extensive intraductal component (EIC), lympho-vascular invasion and nodal status are associated with an increased risk of loco-regional recurrence (LRR) after BCS
Summary
A number of patients treated conservatively for breast cancer will develop loco-regional and distant recurrences. There was a shift from the orthodox treatment applying modified radical mastectomy (MRM) to breast conservative surgery (BCS) with radiotherapy [1,2,3,4]; BCS became the standard treatment for patients with early breast cancer. It provides a better quality of life for these patients and has the same overall survival if compared with mastectomy. It is associated with a higher incidence of loco-regional recurrence. This event may be a biomarker of disease aggressiveness as distant spread is a frequent accompaniment [5,6,7,8,9,10,11].
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