A clinicopathological comparison of late recurrences occurring after 5 years with early recurrences occurring in the first 5 years in patients with operated breast cancer and assessment of survival rate

The greatest problem in breast cancer patients who were treated with adjuvant therapy is recurrence of the disease. Recurrences are usually seen in the first 5 years. There is varied information in the literature regarding recurrence in the first 5 years and after 5 years according to the patient characteristics. This study aims to compare the clinical pathological characteristics of patients with early recurrence in the first 5 years and late recurrence after 5 years and to evaluate survival. For this purpose, a total of 854 followed-up patients, 637 with recurrence and 217 in 10-year remission, who have been operated for metastatic and/or non-bilateral, invasive breast cancer, over 18 years of age at Hacettepe University Faculty of Medicine Department of Medical Oncology was included in the study. The median follow-up time of patients was 105 months (3-426 months). Group of patients with recurrence 5 year survival rate was %71,5±1,8. Patients with recurrence and in remission for at least 10 years were compared and it was seen that presence of obesity, existence of perineural invasion-lymphovascular invasion-extracapsular extension, grade, T and N stages effected the recurrence and disease-free survival. According to the recurrence periods, the risk was 1.51 times [95% Confidence Interval (CI): 1.17-1.96] higher for the recurrences in the first 5 years, in the existence of lymphovascular invasion (LVI) during the multivariate analyses, the risk was 2.05 times (CI: 1.56-2.69) higher with tumors that are estrogen receptor (ER)-negative and/or progesterone receptor (PR)-negative and the risk was 1.2 times (CI: 0.95-1.7) higher in N3 tumors compared with N1 tumors with a borderline statistically significant effect. According to the multivariate analyses for 6 to 10 years of recurrence, the recurrence risk in patients with LVI was 1.79 times (CI: 1.47-2.2) higher. For the recurrences after 10 years, the disease-free survival period was shorter only in the existence of breastfeeding with a borderline statistically significant effect (p=0.049). Keywords: breast cancer, early recurrence, late recurrence, disease-free survival Keywords: breast cancer, early recurrence, late recurrence, disease-free survival