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. 2023 Dec;202(3):551-561.
doi: 10.1007/s10549-023-07089-6. Epub 2023 Sep 14.

Long-term locoregional recurrence in patients treated for breast cancer

Beatriz Costeira  1   2 , Francisca Brito da Silva  3 , Filipa Fonseca  3 , Rodrigo Oom  3 , Cristina Costa  3 , João Vargas Moniz  3 , Nuno Abecasis  4 , Catarina Rodrigues Santos  3   5
Affiliations

Long-term locoregional recurrence in patients treated for breast cancer

Beatriz Costeira et al. Breast Cancer Res Treat. 2023 Dec.

Abstract

Background/purpose: Locoregional control in breast cancer is a fundamental part of treatment and determinant for survival outcomes. It has been reported that most locoregional recurrence (LRR) events occur in the first 5 years after treatment. However, LRR continue to occur after this timeline, with unclear risk factors and unknown survival impact.

Methods: Retrospective singe-centered cohort of patients treated for primary breast cancer, between January 2002 and December 2004. Primary outcome was LRR; secondary outcomes were overall survival (OS), disease-free survival (DFS), and predictive factors for LRR.

Results: This analysis included 1001 patients, of which 959 (95%) had invasive carcinoma. A mastectomy was performed in 501 (50%) and 500 (50%) had breast conservative surgery (BCS). Median follow-up time was 197 [Inter-quartile range (IQR) 96-211] months. Global LRR rate was 7.6%, with median time to recurrence of 45 [IQR 21-91] months. There was no difference in LRR rate after mastectomy vs BCS, adjusted to tumor stage (p > 0.05). The 10-year OS and DFS rates were 68.4 and 77.8%, respectively. Factors associated with LRR were metastatic axillary lymph nodes and high histologic grade (p < 0.05). Estrogen-negative (ER) tumors had higher LRR rates than ER-positive tumors in the first 5 years (p < 0.05); but no difference was observed with longer follow-up (p > 0.05). LRR was associated with OS (p < 0.05).

Discussion and conclusions: Global LRR in this cohort was 7.6% (with over 16 years of follow-up). LRR associates with decreased OS. Time to LRR varies significantly with tumor biology, supporting differentiation of follow-up regimens.

Keywords: Breast neoplasm; Breast-conserving surgery; Local neoplasm recurrence; Mastectomy; Survival Analysis.

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