Clinicopathological Features and Prognostic Factors Affecting Survival Outcomes in Isolated Locoregional Recurrence of Breast Cancer: Single-Institutional Series

Abstract

PurposeThe purpose of this study was to investigate the clinicopathologic features and prognostic factors affecting outcome in patients with isolated locoregional recurrence of breast cancer (ILRR).MethodsWe retrospectively analyzed the medical records of 104 patients who were diagnosed with ILRR and underwent curative surgery from January 2000 to December 2010 at Samsung Medical Center.ResultsAmong 104 patients, 43 (41%) underwent total mastectomy and 61 (59%) underwent breast-conserving surgery for primary breast cancer. The median time from initial operation to ILRR was 35.7 months (4.5–132.3 months). After diagnosis of ILRR, 45 (43%) patients were treated with mastectomy, 41 (39%) with excision of recurred lesion, and 18 (17%) with node dissection. During a median follow-up of 8.9 years, the 5-year overall survival was 77% and 5-year distant metastasis-free survival (DMFS) was 54%. On multivariate analysis, younger age (< 35 years), higher stage, early onset of elapse (≤ 24 months), lymph node recurrences, and subtype of triple negative breast cancer (TNBC) were found to be independently associated with DMFS. Patients in the no chemotherapy group showed a longer DMFS after surgery for ILRR than those treated with chemotherapy (median 101.5 vs. 48.0 months, p = 0.072) but without statistical significance.ConclusionOur analysis showed that younger age (< 35 years), higher stage, early onset of relapse (≤ 24 months), lymph node recurrence, and subtype of TNBC are the worst prognostic factors for ILRR.

Prognostic value and management of regional lymph nodes in locoregional breast cancer recurrence: a systematic review of the literature

“…In 104 patients with ipsilateral locoregional recurrence, 35 patients (33.7%) had a regional lymph node recurrence. Compared to recurrent disease limited to the breast or chest wall, recurrent disease in regional lymph nodes was identified as an independent and significant prognostic factor for distant metastasis during a median follow-up of 8.9 years (HR of 2.816 (95% CI: 1.342–5.908, p : 0.006)) [ 4 ].…”

“…In the study of Montagna et al regional recurrence is defined as cancer in the axillary, internal mammary, supraclavicular or infraclavicular lymph nodes [ 3 ]. Lee et al and Anderson et al additionally count cervical lymph nodes and ipsilateral chest wall/non breast skin, respectively, to regional disease [ 1 , 4 ].…”

P53 and Ki-67 as prognostic markers in triple-negative breast cancer patients

“…The number of cancer-related parameters available to predict the prognosis of breast cancer patients has grown considerably in recent years. Prognostic factors of breast cancer include histological features (histological type, histological grade, lymphovascular invasion), tumor size, lymph node status, steroid hormone receptors status and age [ 7 – 9 ]. Prognostic and predictive biomarkers, including p53 [ 10 ] and Ki-67 [ 11 ], were also identified in breast cancer.…”

Elevated levels of eEF1A2 protein expression in triple negative breast cancer relate with poor prognosis

“…Breast cancer is the most common cancer in women, and the second most frequent cause of cancer-related deaths in women worldwide [1,2]. Prognostic factors include histological features (histological type, histological grade, lymphovascular invasion), tumor size, lymph node status, steroid hormone receptors status and age [3–5]. Molecular stratification based on gene expression profiling revealed that breast cancers could be classified in the so-called intrinsic subtypes-Luminal A, Luminal B, HER2-enriched, basal-like, and normal-like- [6], which correlate with the efficacy of chemotherapy and life expectancy [7].…”