Effect Of Breast Invasive Ductal Carcinoma With EIC On Local Recurrence After Breast Conserving Surgery

Objective:To retrospectively analyze the effect of invasive ductal carcinoma with extensive intraductal components(EIC)and other clinicopathological factors on local recurrence and survival after breast conserving surgery.Methods:The data of patients with early breast cancer who underwent breast-conserving surgery in The Second Affiliated Hospital of Soochow university from January 1,2008 to December 31,2015 were collected and followed up.A total of 182 patients with breast invasive ductal carcinoma who had complete data were eligible for inclusion criteria.The clinicopathological features of two groups of breast cancer patients with EIC positive(n=23)and EIC negative(n=159)were compared and the local recurrence rate and survival of the two groups were analyzed.All statistical analyses were carried out with SPSS 19.0 for Windows.Results:The follow-up was up to May 31,2017,a total of 182 patients who met the inclusion criteria completed follow-up and the median follow-up was 48 months(range,12 to 113 months).Of the 182 patients with invasive ductal breast cancer,23(12.6%)were EIC positive and 159(87.4%)were EIC negative.There were no statistically significant differences in age,menstrual status,family history of breast cancer,tumor size,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor 2(HER-2),Ki-67,molecular typing,vascular status,histological grade,chemotherapy or not between the two groups.In the lymph node status,the lymph node metastasis rate was higher in the EIC-positive group(47.8%VS 18.9%,P=0.002),and the difference was statistically significant.There were 8 cases of ipsilateral breast recurrence(4.4%),and 7 cases(3.8%)of distant metastasis.In the EIC positive group,ipsilateral breast tumor recurrence(IBTR)was 21.7%(5/23)and the distant metastasis rate was 4.3%(1/23);in the EIC negative group,ipsilateral breast tumor recurrence(IBTR)was 1.9%(3/159)and the distant metastasis rate was 3.8%(6/159).The Kaplan-Meier curve showed that the 5-year local recurrence-free survival rates in the EIC positive group was lower than that of the EIC negative group(78%VS 97.7%,P<0.001),and the difference was statistically significant,but the 5-year distant metastasis-free survival rates in the two groups was similar(95.7%VS 96.2%,(P=0.892),with no statistical significance.COX multivariate analysis showed that EIC was an independent risk factor for local recurrence after breast-conserving surgery in breast invasive ductal carcinoma patients.Conclusion:EIC increase the local recurrence rate in patients with breast invasive ductal carcinoma.For such patients to choose breast-conserving surgery should be adequately preoperative evaluated to avoid local recurrence leading to breast-conservation failure.