Publications

Five-year local recurrence for breast cancer: The presentation of our local data

Published Date: 25th April 2017

Publication Authors: Clifford R, Antoniadis S, Chagla LS

​Background

Breast cancer is the most common cancer in women, affecting 1 in 8 worldwide. Overall survival has now reached 80% at 5 years, with improved targeted therapy. Although a large amount of data is collected for national audit, in the UK local recurrence rate is largely unknown. 

Methods

Retrospective analysis of prospectively collected data for all patients diagnosed with breast cancer at our local Trust from

2005-2009 to enable 5 year follow up. Comparison to current literature and statistical analysis of our results was

performed using a standard statistical package.

Results

1075 patients were identified. 137 (12.64%) patients had breast cancer related deaths, giving overall 5 year survival of 74.7%. 154 (14.3%) patients developed metastatic disease without local recurrence, and 19 (1.74%) local recurrence. Overall survival for patients with local recurrence dropped to 69.5%. 78.9% of patients self-presented with their recurrence out of the surveillance program. A multiple logistic regression model was created using the individually statistically significant variables (histological grade, Sentinel Lymph Node (SLN) positivity, tumour size). The analysis highlighted a likelihood ration of 3.08 (95%) Cl1.81-5.43) for SLN positivity, and 1.97 (95% Cl 1.11-3.4) for tumour size; no other variables contributed significantly to the model.

Conclusion

Our local recurrence rate is significantly lower than the perceived rate of 1-2% per year. An overall analysis of all histological variables attributes more clinical significance when assessing an individual's probability of recurrence. Patient self-assessment detected the majority of local recurrence; questioning the benefit of annual clinician review and in keeping with the national drive.

Clifford, R; Antoniadis, S; Chagla, L. (2016). Five-year local recurrence for breast cancer: The presentation of our local data . European Journal of Surgical Oncology. 42 (5), S17

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