Biological subtypes of breast cancer and their impact on recurrence and survival rates: Alexandria surgical oncology unit experience

ABSTRACT The effect of breast cancer molecular subtypes and treatment on survival, loco regional and distant recurrences were analyzed. Aiming to decrease the incidence of recurrence, continuous urgue exists about the optimal surgical decision (BCS or mastectomy) to breast cancer subtypes (Triple negative breast cancer and her2 enriched. Alexandria Surgical Oncology Unit Data base was used to identify eligible breast cancer patient. Female patients who were diagnosed and/or treated from January 2000 to December 2010 with primary, invasive, unilateral breast cancer at our hospital were included. A total of 664 patients made up the study population. Kaplan Meier curves and log rank tests were used to estimate 5 year Loco regional and distant recurrence and to compare them across strata. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals to fit the effect of conservative surgery, mastectomy and other independent variables. After a median follow up of 5 year (range 1 10), 16 (6.72%) patients in the BCS groups had Loco regional recurrence (LRR) versus 10(2.34%) patients in the mastectomy group. For distant recurrence, 37(8.68%) patients had distant recurrence in the mastectomy group versus 10(4.2%) patients in the BCS group. Lymphovascular invasion (HR 2.55; 95% CI, 076 to 8.49) and an extensive intraductal component (HR, 2.22; 95% CI, 0.69 to 7.15) are risk factors for (LRR) after BCT, however nodal status represents a risk factor for (LRR) after both BCS & MRM. Tumor size, nodal status, high histologic grade & breast cancer diagnosed at a young age (≤ 35 years) are correlated with higher distant recurrence rates after BCT, whereas lymphovascular invasion & triple negative breast cancer and Her 2 enriched breast cancer are predictive of the risk of distant recurrence after MRM. One of the main predictors of breast cancer survival is molecular subtypes. 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