Prognostic Factors for Breast Cancer Recurrence after Conservative Treatment

Abstract

Breast cancer is nowadays a real public health problem all over the world. Conservative therapy has been one of the approved treatment options for several years. The objective of this work was to describe the prognostic factors of breast cancer recurrence in our context after conservative treatment. We performed a retrospective study with analysis of clinical, pathological, and therapeutic parameters in patients with breast cancer recurrence after conservative treatment over a period of 2 years. During the study period, a total of 17 patients were selected. The mean age at diagnosis of the primary tumor was 54.56 years. The occurrence of recurrence was correlated with advanced tumor size with a rate of 64.7% for stage 2, lymph node invasion in 11 patients or 41.18%, and the presence of metastasis which was present in 2 patients. On the other hand, invasive ductal carcinoma was the most frequent histological type with 13 cases (76.47%) with predominantly intermediate or high SBR histopronostic grades (II and III: 47.05% each), vascular emboli and Comedonecrosis was present in 3 patients (17.64%), and the resection margins were healthy in all patients. As for estrogen receptors, they were positive in 9 patients, i.e., 52.94% of cases and those of a progesterone type were present in 8 patients (47.05%), HER-2 receptors were overexpressed in 3 patients (17.64%) and Ag Ki67 was greater than 20 in 76.47% of cases. Thus, 8.33% of the tumors were classified Luminal A, 47.06% were Luminal B, 11.76% were of the HER-2 type, and 35.29% were triple negative. All our patients had benefited from conservative treatment of the primary tumor made by conservative surgery followed by radiotherapy, with a delay between surgery and radiotherapy ranging from 8 to 23 months in patients who received chemotherapy and an average of 11 months, and from 4 to 8 months in patients who received radiotherapy directly after surgery, for an average of 5.25 months, on the other hand, adjuvant chemotherapy was administered in 11 patients (64.70%), hormone therapy was prescribed for 9 patients (52.94%) and only one patient had benefited from targeted therapy such as HERCEPTIN. In conclusion, conservative treatment is currently indicated in most T1 and T2 mammary carcinomas given that it constitutes a therapeutic alternative combining carcinological and aesthetic benefits, however much remains to be done to be able to optimize its results and thus minimize the risk of recurrence.