Study On The Risk Factors Of Local Recurrence After Breast Conserving Surgery In Breast Cancer

Background and objective: Currently,breast cancer is the most common cancer in Chinese women.This trend is also observed in many other countries.And 12.2% of newly diagnosed breast cancers and 9.6% of deaths due to breast cancer worldwide are from cancer patients in China.In the United States,women younger than 40 years old account for 6.6% of breast cancer cases.According to International Agency for Research on Cancer,breast cancer cases in women less than 40 years old accounted for 12.56% of all breast cancers in China in 2008,much higher than the proportion in western countries.It is commonly recognized that young breast cancer patients are likely to have higher degree of tumor malignancy,higher rate of relapse within an early time period,and worse prognosis.It is of great clinical importance and social value to investigate biological indicators for breast cancer prognosis,especially for young patients in China.The different molecular subtypes reflect the biological diversity of breast cancer.In a time in which medicine is moving toward a personalized approach,a critical goal is the correlation of the different disease subtypes with clinical outcomes and targeted therapeutics.Several studies have evaluated the variance in systemic disease recurrence and survival among the intrinsic subtypes.To this end,additional work has pointed toward the growing significance of molecular subtypes in the risk of locoregional recurrence along with clinical and pathologic features.Objective: The effects of biological subtypes within breast cancer on prognosis are influenced by age at diagnosis,this study aims to figure out the correlation between young age and locoregional recurrence(LRR)according to hormone receptor state in breast cancer patients underwent breast conserving surgery(BCS).Methods: Totally 765 cases of breast cancer patients treated with BCS in Tianjin Medical University Cancer Institute &Hospital between 2000 to 2010 were identified retrospectively.Predictors of locoregional recurrence-free survival rate(LRRFS)were evaluated by uni-and multivariate analysis.Results: Median follow up was 103 months(range,22 to 184 months).For all patients the 10-year LRRFS was 90.2%.Of all patients,82 were aged < 35 years,683 were aged ≥35 years.The 10-year LRRFS of patients aged < 35 years is lower than aged ≥35 years groups(83.5%for<35 岁 vs 95.2%for ≥35 岁,p<0.01).We only found this passive impact of very young age on LRR in hormone receptor positive breast cancer patients(83.0% for<35 岁,94.9%for≥35 岁,p<0.01).Multivariate analysis indicated that hormone receptor positive in patients <35 years increased the risk of LRR((HR,3.58;p <0.01,HR,2.87;p = 0.01)Conclusion:Very young breast cancer patients treated with BCS increased the risk of LRR.This passive effect was restrained in hormone receptor positive breast cancer patients.