Locoregional recurrences of breast cancer after reconstructive plastic and organ-preserving surgery

Abstract

Objective. To analyze locoregional relapses (LRR) after reconstructive plastic and organ-preserving operations in breast cancer (BC)Materials and methods. A retrospective analysis of the results of the treatment of 303 patients with BC who underwent reconstructive plastic and organ-preserving operations in the period from 2014 to 2019 in the Oncological Department of General Oncology and Rehabilitation of Gomel Regional Clinical Oncological Dispensary was carried out. The median age was 44 years (25-70 years). Statistical data processing was carried out using the application software package “Statistica”, 10.0. To characterize the surveyed groups, a standard methodological approach based on the calculation of descriptive statistics data was used. In order to statistically assess the relationship between the frequency of relapses depending on the stage and the molecular biological type of neoplasm, the Spearman correlation coeffi cient was used. The accepted level of statistical signifi cance (p) was 0.05.Results. Locoregional relapses were recorded in 11 (3.6%) patients, of which local — in 8 (2.6%), regional — in 3 (1.0%). The minimum period of development of LRR was 15 months, the maximum was 74 months; the median period of occurrence of LRR was 47 months. Depending on the stage of breast cancer, relapses developed: at stage I — in 4 (3.7%) cases, II — 5 (3.5%), III — 2 (4.2%). Depending on the molecular biological subtype of the neoplasm, LRR were distributed as follows: with luminal A — 1 (1.3%) case, luminal In HER2-negative — 1 (0.9%), luminal In HER2-positive — 6 (9.7%), non-luminal HER2-positive 1 (6.3%), three times negative — 2 (5.6%). Discordance of the receptor status was detected in 8 (72.7%) patients with recurrent tumor, most often due to the loss or decrease in the number of progesterone receptors (PR). The level of tumor-infi ltrating lymphocytes (TILs) in primary neoplasm ranged from 4 to 12%, in recurrent tumors it remained low: 5-10%.Conclusion. Given the heterogeneity of BC, the risk of developing LRR depends on many factors. LRR developed in luminal HER2-positive cancer in 9.7% of cases (p 0.05), stage III breast cancer — 4.2% (p 0.05). One of the important predictive factors is the evaluation of TILs. We noted a low level of TILs in both primary and recurrent tumors. There is a high discordance in the receptor status — 72.7%, which is important to take into account when prescribing systemic therapy.