Predictors for locoregional recurrent breast cancer in Egyptian females

Abstract

Introduction: Locoregional recurrence (LRR) after proper therapy for breast cancer is not uncommon; it represents around 13%. LRR is classified into true recurrence (TR) or new primary (NP) breast cancer. In true recurrence (TR), some cells may survive and multiply to be detected after mastectomy or breast conservative surgery (BCS). However, in new primary (NP) breast cancer, de novo cancer cells arising from preserved breast tissue after BCS in spite of proper treatment to eliminate all cancer cells. Aim: The aim of the study was to assess and identify the predictors for locoregional recurrent breast cancer in Egyptian females as there is a lack of studying these factors among them. Patients and methods: The study was conducted retrospectively on 60 female patients with locoregional recurrent breast cancer presented to Alexandria Main University Hospital, Surgical Oncology Unit with exclusion criteria of bilateral breast cancer and male breast cancer. Results: 30 cases had a recurrence after BCS while the other 30 cases had a recurrence after modified radical mastectomy (MRM), the mean age of the patients was 36.67 years. 40 cases harvested less than ten lymph nodes with 42 cases have ≥ 4 lymph nodes affected. Regarding the 30 cases that had undergone BCS; 16 cases had negative margin in the frozen section, 12 cases had close margin, and 2 cases were negative in frozen section while positive in paraffin. Pathologically, 34 cases were grade II, 38 cases had a lymphovascular invasion, 24 cases had an extracapsular extension, 28 cases were ER-positive, and 54 cases were negative for Her 2neo. Conclusion: Predictive factors of significance for local failure are young age, positive resection margins, lymphovascular invasion, and heavy affection of axillary lymph nodes, extracapsular extension, extensive intraductal component, and high histologic grade. Some of these predictive factors proved to be significant in this study.