Retrospective study of pattern of recurrence of breast cancer after surgery and adjuvant therapy | ||||
| Sohag Medical Journal | ||||
| Article 8, Volume 22, Issue 2, July 2018, Page 51-60 PDF (85.78 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2018.34691 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Mohmed Soliman Gaber; Emad El Din Nabil Hassan; Aya Mahmoud Ibraheem | ||||
| Department of Clinical Oncology ,Faculty of Medicine,Sohag University. | ||||
| Abstract | ||||
| Aim of the work:investigate pattern of breast cancer recurrence and the affecting factors on early and late recurrence and identify factors affecting site specific recurrence. Patients and methods:A retrospective study of 141 patients presented to clinical oncology department ,sohag university hospital between January 2000 and December 2014 diagnosed with invasive breast cancer.All of them underwent surgery either modified radical mastectomy,simple mastectomy or breast conservative surgery then received adjuvant systemic therapyeitherchemotherapy,endocrine therapy or both.Adjuvant radiotherapy was given when indicated.This study was conducted by hand search in the files. Results:90%(n=127) of our patients develop recurrence in first 5 year with 64.5%(n=91) of total number of patient in first 3 year. Patients still have risk of recurrence even after 10 years after primary treatment as 2 patients develop recurrence after 10 years. Among 141 patients with recurrence, 116 patients (82.2%) and 32 (22.6%) were involved with distant and loco regional recurrence, respectively.The most prevalent distant metastasis was seen in bone with liver , lung and brain metastasis in descending manner. Multiple organ metastasis was detected in 36% of patients. In our study in early recurrence group 70% (n=89) had tumor size more than 2 cm ,88%(n=113) had positive axillary lymph node ,98%(n=125) had high tumor grade indicate that tumor size larger than 2 cm, axillary lymph node involvement ,high tumor grade tend to be important prognostic factors in early recurrence. The present study has demonstrated that there is no significant tumor or patient characteristic associated with the site-specific risks of metastasis. Conclusion:Most breast cancer recurrence occur during first 5 year with peakincidence in1and 2year.Tumor size larger than2cm, lymph node involvement and high tumor grade tend to be important prognostic factors in early recurrence before 5 year. The most common exclusive first site of metastasis was bone and the least common is the brain.The current clinical practice of screening for site specific metastatic disease based on concerning patient specific signs or symptoms is supported. | ||||
|
Supplementary Files
|
||||
| References | ||||
|
1) Ferlay J, Soerjomataram I, Ervik M, Dikshit RP, Eser S, Mathers C, et al.GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer 2013. [http://globocan.iarc.fr/]
2) Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet.2005;365:1687–717.
3) Devita VT, Lawrence TS, Rosenberg SA, DePinhoR,Weinberg RD. Hellman, and rosenberg’s cancer: Principles and practice of oncology. Cancer: Principles and Practice Philadelphia: Lippincott Williams and Wilkins; 2008.
4) Popoola AO, Ibrahim NA, Omodele FO, Oludara MA, Adebowale SA, Igwilo AI. Pattern of spread of breast cancer among patients attending cancer unit of lagos state university teaching hospital. Asian J Med Sci.2012;4(3):89–91.
5) Jemal A, Bray F, Melissa M,JacquesFerlay,ElizabethWard,DavidForman,Center MM. Global cancer statistics. CA Cancer J Clin 2011; 61:69.
6) Karrison TG, Ferguson DJ, Meier P (1999) Dormancy of mammary carcinoma after mastectomy. J Natl Cancer Inst 91: 80–85.
7) Peto R, Boreham J, Clarke M, Davies C, Beral V (2000) UK and USA breastcancer deaths down 25% in year 2000 at ages 20–69 years. Lancet 355: 1822.
8) Saphner T, Tormey DC, Gray R (1996) Annual hazard rates of recurrence forbreast cancer after primary therapy. J ClinOncol 14: 2738–2746.
9) M Clarke, R Collins, S Darby, C Davies, V Evans, J Godwin, R Gray, P McGale, R Peto, and Y Wang:Early Breast Cancer Trialists’ Collaborative Group (EBCTCG): Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet 365:1687-1717, 2005.
10) Dawood S, Broglio K, Ensor J, Hortobagyi GN, Giordano SH. Survival differences among women with de novo stage IV and relapsed breast cancer. Ann Oncol 2010; 21: 2169-2174.
11) Marco Colleoni, Zhuoxin Sun, Karen N. Price, Per Karlsson, John F. Forbes, Beat Th¨urlimann, Lorenzo Gianni, Monica Castiglione, Richard D. Gelber, Alan S. Coates, and AronGoldhirsch, Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up : Results From the International Breast Cancer Study Group Trials I to V study, VOLUME 34 • NUMBER 9 • MARCH 20, 2016,JOURNAL OF CLINICAL ONCOLOGY.
12) Lee CH, Dershaw DD, Kopans D, et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am CollRadiol 2010; 7:18.
13) Popoola AO, Ibrahim NA, Omodele FO, Oludara MA, Adebowale SA, Igwilo AI. Pattern of spread of breast cancer among patients attending cancer unit of lagos state university teaching hospital. Asian J Med Sci.2012;4(3):89–91.
14) Sestak I, Dowsett M, Zabaglo L, Lopez-Knowles E, Ferree S, CowensJW,et al. Factors predicting late recurrence for estrogen receptor-positive breast cancer. J Natl Cancer Inst. 2013;105:1504–11.
15) Rosa Mendoza ES, Moreno E, Caguioa PB. Predictors of early distant metastasis in women with breast cancer. J Cancer Res ClinOncol. 2013;139(4):645–52. doi: 10.1007/s00432-012-1367-z. [PubMed:23283528].
16) PattarapornWangchinda and SuthineeIthimakin:Factors that predict recurrence later than 5 years after initial treatment in operable breast cancer (Wangchinda and Ithimakin World Journal of Surgical Oncology (2016) 14:223 DOI 10.1186/s12957-016-0988-0).
17) Won Jong Song, Kwan Il Kim, Sang Hyun Park, MiSeon Kwon, Tae Hoon Lee, Heung Kyu Park, Jung Suk An1 ,The Risk Factors Influencing between the Early and Late Recurrence in Systemic Recurrent Breast Cancer, journal of breast cancer 2012 June; 15(2): 218-223
18) E Colzani*,1, A L V Johansson1, A Liljegren2, T Foukakis2, M Clements1, J Adolfsson3, P Hall1 and K Czene1 ,Time-dependent risk of developing distant metastasis in breast cancer patients according to treatment, age and tumourcharacterstic,British Journal of cancer(,2014) 110, 1378-1384|doi:10.1038/bjc.2014.5
19) Yücel B, Bahar S, Kaçan T, Şeker MM, Celasun MG. Importance of Metastasis Site in Survival of Patients with Breast Cancer. Austin J Med Oncol. 2014;1(2): 7.
20) Minn AJ, Gupta GP, Padua D, et al: Lung metastasis genes couple breast tumor size and metastatic spread. ProcNatlAcadSci U S A 104:6740-6745, 2007
21) Dawood S, Broglio K, Esteva FJ, et al: Defining prognosis for women with breast cancer and CNS metastases by HER2 status. Ann Oncol 19:1242-1248, 200
22) Abigail T. Berman,1 Arpi D. Thukral,1 Wei-Ting Hwang,2 Lawrence J. Solin,1 Neha Vapiwala1 Incidence and Patterns of Distant Metastases for Patients With Early-Stage Breast Cancer After Breast Conservation Treatment Clinical Breast Cancer, Vol. 13, No. 2, 88-94 © 2013 Elsevier Inc.
23) Hagen Kennecke, RinatYerushalmi, Ryan Woods, Maggie Chon U. Cheang, David Voduc, Caroline H. Speers,Torsten O. Nielsen, and Karen Gelmon, Metastatic Behavior of Breast Cancer SubtypesJOURNAL OF CLINICAL ONCOLOGYVOLUME 28 _ NUMBER 20 _ JULY 10 2010 | ||||
|
Statistics Article View: 262 PDF Download: 268 |
||||
