Prognostic Factors Affecting Ipsilateral Breast Tumor Recurrence in Breast-Conserving Surgery

INTRODUCTION: Breast cancer is the most common malignancy among women worldwide. Breast-conserving surgery (BCS) is the standard surgical treatment for patients with early-stage breast cancer. Fear of recurrence strongly influences surgical decision-making and significantly impacts the long-term quality of life in breast cancer survivors. The aim of this study was to investigate the independent prognostic factors associated with the risk of ipsilateral breast tumor recurrence (IBTR).
METHODS: A total of 1,388 female patients diagnosed with breast cancer and treated with breast-conserving surgery (BCS) at our hospital between January 2003 and December 2011 were retrospectively evaluated.
RESULTS: The median age of the patients was 50 years (range: 24–85). Mean overall survival was 68.2 months (SD±35.2), and mean disease-free survival was 64 months (SD±33.1). During follow-up, locoregional recurrence (LRR) occurred in 93 patients (6.7%): 67 had local (IBTR), 15 regional, and 11 both local and regional recurrences. Age, presence of lymphovascular invasion, surgical margin status, hormone receptor negativity, and high nuclear grade were significant predictors of recurrence (p<0.001). Recurrence rates rose from 3.6% with surgical margins ≥5 mm to 12.3% with margins <5 mm. Among patients with distant metastasis, 32.1% had LRR, and 42.3% of deaths were linked to LRR.
DISCUSSION AND CONCLUSION: IBTR remains a significant risk factor for breast cancer–related mortality. Special attention should be given to patients with high-risk prognostic factors, and careful evaluation of surgical margin status is of paramount importance.

Keywords: Breast cancer, breast conserving surgery, local recurrence, prognostic factor, surgical margin.