Abstract 899: Patterns of distant and local relapses in breast cancer patients and triple negative subgroup
Authors: Conson Manuel , D'Amato Gianluca , Nieddu Valeria , Pagliarulo Clorindo , Iorio Vincenzo , Vernieri Claudio , Farella Antonio , Solla Raffaele , Cella Laura , Liuzzi Raffaele , Punzo Giorgio , Salvatore Marco , Pacelli Roberto 
Published: February 2011

Abstract
Aim: In patients treated for localized breast cancer, incidence, localization, and time of recurrences were registered and analyzed with the purpose of defining possible differences in site and /or time of failures associated with triple negative histology (ER-, PgR-, ERB-B2-) .
Patients and Methods: Five hundred eighty five consecutive female patients affected by localized breast cancer treated at our department between January 1999 and December 2006 were considered. Median age was 53 years (range 27 − 84). Firty five (7.9%) patients were at Stage 0 of disease, 272 (47.6%) Stage I, 206 (36%) Stage II, and 49 (8.5%) Stage III. Fifty nine (13.5%) of 440 assessable patients resulted triple negative. All patients were treated by surgery (breast sparing 552 (94.4%), mastectomy 33 (5.6%)) plus postoperative radiation therapy at doses of 50 Gy in 5 weeks, on the breast or thoracic wall and nodal regions, plus, in the case of breast conserving surgery, 10 Gy in a week on the tumoral bed. Chemotherapy, hormonal therapy or both was administered to 170, 168 and 161 patients respectively. Time and localization of recurrences were registered and analyzed relatively to the whole population and triple negative status.
Results: At a median follow up of 61 months (range 3-137) 18 (3.1%) local and 41 (7.0%) distant relapses were registered. Thirty one (5.3%) patients died of which 23 (3.9%) for breast cancer. Sites of first distant metastasis detection were bone (25%), liver (17%), lung (15%), brain (8%). In 34% of cases the detection of metastatic disease at exordium was represented by the contemporary appearance of multiple organ involvement. The median time to distant metastasis relapse resulted 34 months (range 8 − 117) with 88% of relapses before 60 months for the whole group. However in the triple negative subgroup the rate of distant relapse resulted 13.5% and local relapse 5.1%. Median time to distant relapse was 25 (8 − 48) months. Locoregional relapses were mostly in the breast or thoracic wall (16, 89%), with fewer nodal relapses (2, 11%). The median time to locoregional relapse was 32 months (8 − 78) with 78% of relapse before than 60 months and no differences were found in the patterns of relapse between the groups.
Conclusions: In our experience localized breast cancer distal recurrences mostly involves primarily bone, liver, and lung with about one third of patients having multiple organ metastatic exordium. In triple negative subgroup there was an increased risk of distant relapse with a shorter median time. No difference in time and site patterns were found relatively to locoregional recurrences.
Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 899.