Risk factors for local recurrence after breast-conserving surgery

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Uncertainty exists regarding differing risk factors for local recurrence in breast-conserving surgery for in situ versus invasive breast cancer.
• The role of Nottingham Prognostic Index (NPI) and Nottingham Histological Grade (NHG) in predicting local recurrence risk requires further investigation.

Purpose of the Study:

• To identify risk factors for local recurrence following breast-conserving surgery for both in situ and invasive breast cancer.
• To evaluate the predictive value of NPI and NHG for local recurrence risk.

Main Methods:

• A case-control study nested within a cohort of 7502 women undergoing surgery for breast cancer (in situ or invasive).
• Evaluation of patient, tumor, and treatment variables as risk factors for local recurrence using multivariate conditional logistic regression.

Main Results:

• Significant risk factors for local recurrence included age under 40, tumor multicentricity, and unclear/unknown surgical margins.
• Radiotherapy and adjuvant hormone therapy demonstrated a protective effect against local recurrence.
• No significant difference in local recurrence risk was observed between in situ and invasive breast cancer; NHG and NPI were not predictive.

Conclusions:

• Surgical margin status, patient age, tumor multicentricity, radiotherapy, and adjuvant hormone therapy are key determinants of local recurrence risk.
• Except for surgical margin, factors related to surgical management quality did not predict local recurrence risk.