Histologic multifocality is predictive of skin recurrences after conserving treatment of stage I and II breast cancers

Objective. To distinguish various types of local recurrence after conservin g treatment of breast cancer and to evaluate their predictive value. Materials and methods. We first researched the pronostic factors after loca l recurrence and second evaluated the predictive factors of skin and inflam matory recurrences out of a series of 605 cases of stage I and stage II bre ast cancer of less than 4 cm in diameter that occurred after conserving tre atment. Results. Multivariate analysis revealed two major predictors of poor progno sis associated with recurrence: early appearance Hazard ratio 3.0 (1.28-7.0 0) (p = 0.011) and inflammatory or skin involvement Hazard ratio 3.38 (1.36 -8.45) (p = 0.009). A local recurrence multiplied the relative risk for met astasis by 2.6. This result depended on the type of recurrence: when those with inflammatory and cutaneous types were excluded, local recurrence was n o longer a poor prognostic factor. Patients who experienced primary invasiv e tumor with histologic multifocality have a 4.08 (1.44-11.59) (p < 0.004) times greater risk of developing cutaneous or inflammatory recurrences comp ared with patients who experienced breast cancer unique localization. Conclusion. As histologic multifocality is the only factor predictive of da rk prognosis local breast cancer recurrences, aggressive therapy at the tim e of the primary treatment could be the therapeutic implications of such fi nding on the original tumor.