Risk Factors for Local Recurrence After Breast-conserving Surgery

Overview

Journal Br J Surg

Specialty General Surgery

Date 2003 Aug 29

PMID 12945077

Citations 20

Authors

I Fredriksson

G Liljegren

M Palm-Sjovall

L-G Arnesson

S O Emdin

T Fornander

A Lindgren

H Nordgren

I Idvall

M Holmqvist

L Holmberg

J Frisell

Affiliations

Soon will be listed here.

Abstract

Background: It is not clear whether risk factors for local recurrence after breast-conserving surgery differ in women having surgery for in situ or invasive cancer. Furthermore, the Nottingham Prognostic Index (NPI) and Nottingham Histological Grade (NHG) have been little studied as determinants of local recurrence risk.

Method: In a case-control study (491 cases and 1098 controls) nested within a cohort of 7502 women who had surgery for in situ or invasive cancer of the breast, patient characteristics, tumour characteristics and treatment-related variables were evaluated as risk factors for local recurrence.

Results: Multivariate conditional logistic regression analyses showed that age below 40 years, tumour multicentricity and an unclear or unknown surgical margin were significant risk factors for local recurrence. Radiotherapy to the breast and adjuvant hormone therapy were protective. Cancer in situ was not associated with a higher risk of local recurrence than invasive cancer (odds ratio 1.0, 95 per cent confidence interval 0.8 to 1.3). NHG and NPI were not helpful in determining risk of local recurrence.

Conclusion: Margin status, age, tumour multicentricity, and use of radiotherapy and adjuvant hormone therapy were important determinants of risk of local recurrence. With the exception of surgical margin, variables related to the quality of surgical management did not predict risk of local recurrence.

Citing Articles

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Clinicogenomic Radiotherapy Classifier Predicting the Need for Intensified Locoregional Treatment After Breast-Conserving Surgery for Early-Stage Breast Cancer.

Sjostrom M, Chang S, Fishbane N, Davicioni E, Zhao S, Hartman L J Clin Oncol. 2019; 37(35):3340-3349.

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Complete excision with narrow margins provides equivalent local control to wider excision in breast conservation for invasive cancer.

Tang S, Rapisarda F, Nerurkar A, Osin P, MacNeill F, Smith I BJS Open. 2019; 3(2):161-168.

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Differences in intra-tumoral macrophage infiltration and radiotherapy response among intrinsic subtypes in pT1-T2 breast cancers treated with breast-conserving surgery.

Garvin S, Patil E, Arnesson L, Oda H, Hedayati E, Lindstrom A Virchows Arch. 2019; 475(2):151-162.

PMID: 30915533 PMC: 6647441. DOI: 10.1007/s00428-019-02563-3.

Interferon-induced protein with tetratricopeptide repeats 1 (IFIT1) as a prognostic marker for local control in T1-2 N0 breast cancer treated with breast-conserving surgery and radiation therapy (BCS + RT).

Danish H, Goyal S, Taunk N, Wu H, Moran M, Haffty B Breast J. 2013; 19(3):231-9.

PMID: 23528130 PMC: 5523984. DOI: 10.1111/tbj.12097.