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Risk factors in breast-conservation therapy
J Borger1, H Kemperman, A Hart
1Department of Radiotherapy, Netherlands Cancer Institute/Antoni van Leeuwenhoek Huis, Amsterdam.
Summary
Younger age and vascular invasion are key factors for local recurrence after breast-conservation therapy (BCT). Identifying these risks improves treatment safety for breast cancer patients.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- Breast-conservation therapy (BCT) is a standard treatment for early-stage breast cancer.
- Assessing risk factors for local recurrence is crucial for optimizing BCT outcomes.
- Patient subgroups may experience different recurrence rates following BCT.
Purpose of the Study:
- To identify clinical and pathological factors predicting local recurrence after BCT.
- To evaluate the safety of BCT across different patient subgroups.
- To refine patient selection for breast-conserving treatments.
Main Methods:
- Retrospective analysis of 1,026 patients with clinical stage I/II breast cancer treated with BCT (local excision, ALND, whole-breast irradiation, and boost).
- Median follow-up of 66 months.
- Statistical analysis including univariate and proportional hazard regression to identify predictive factors for local recurrence.
Main Results:
- Overall actuarial breast recurrence rate was 4% at 5 years.
- Univariate analysis identified seven risk factors: age, residual tumor, tumor type, CIS component, vascular invasion, margin involvement, and radiation dose.
- Independent predictors of local recurrence were young age (<40), margin involvement, and vascular invasion. Young age and vascular invasion remained significant when only early recurrences were considered.
Conclusions:
- Patients under 40 and those with vascular invasion have a higher risk of local recurrence after BCT.
- The role of margin involvement in predicting recurrence requires further investigation.
- Risk stratification can help personalize BCT strategies and improve outcomes.