Prognostic Factors and Surgery for Breast Cancer Patients With Locoregional Recurrence: An Analysis of 5,202 Consecutive Patients

With the application of "less extensive surgery" in breast cancer treatment, the pattern of locoregional recurrence (LRR) has significantly changed. This study aims to evaluate the risk and prognostic factors of LRR in a recent large breast cancer cohort. Consecutive early breast cancer pa...

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Published inFrontiers in oncology Vol. 11; p. 763119
Main Authors Huang, Jiahui, Tong, Yiwei, Chen, Xiaosong, Shen, Kunwei
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 13.10.2021
Subjects
breast cancer
locoregional recurrence
Oncology
risk factors
surgery
survival
locoregional recurrence
breast cancer
risk factors
survival
surgery
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Summary:With the application of "less extensive surgery" in breast cancer treatment, the pattern of locoregional recurrence (LRR) has significantly changed. This study aims to evaluate the risk and prognostic factors of LRR in a recent large breast cancer cohort. Consecutive early breast cancer patients who received surgery from January 2009 to March 2018 in Shanghai Ruijin Hospital were retrospectively analyzed. LRR was defined as recurrence at the ipsilateral breast (IBTR), chest wall, or regional lymph nodes and without concurrent distant metastasis (DM). Patients' characteristics and survival were compared among these groups. Among 5,202 patients included, 87 (1.7%) and 265 (5.1%) experienced LRR and DM as first event after a median 47.0 (3.0-122.5) months' follow-up. LRR was significantly associated with large tumor size and positive lymph node status ( < 0.05). Forty (46.0%) patients received further salvage surgery after LRR and had a significantly better 3-year post-recurrence overall survival than those who did not (94.7% 60.7%, = 0.012). Multivariate analysis showed that salvage surgery for LRR was independently associated with better survival (HR = 0.12, 95% CI 0.02-0.93, = 0.043) along with estrogen receptor (ER) positivity (HR = 0.33, 95% CI 0.12-0.91, = 0.033). LRR rate was relatively low in recent era of breast cancer treatment. Tumor size and lymph node status were associated with risk of LRR, and salvage surgery for selected LRR patients achieved an excellent outcome.
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This article was submitted to Breast Cancer, a section of the journal Frontiers in Oncology
Reviewed by: Shinsuke Sasada, Hiroshima University, Japan; Sota Asaga, Kyorin University Hospital, Japan
Edited by: Tadahiko Shien, Okayama University, Japan
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2021.763119