This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Risk factors for local recurrence after breast‐conserving surgery. BJS 2003; 90: 1093-1102.
Published: 31st July 2003
Authors: I. Fredriksson, G. Liljegren, M. Palm‐Sjövall, L.‐G. Arnesson, S. O. Emdin, T. Fornander et al.
Background
It is not clear whether risk factors for local recurrence after breast‐conserving surgery differ in women having surgery for in situ or invasive cancer. Furthermore, the Nottingham Prognostic Index (NPI) and Nottingham Histological Grade (NHG) have been little studied as determinants of local recurrence risk.
Results
Multivariate conditional logistic regression analyses showed that age below 40 years, tumour multicentricity and an unclear or unknown surgical margin were significant risk factors for local recurrence. Radiotherapy to the breast and adjuvant hormone therapy were protective. Cancer in situ was not associated with a higher risk of local recurrence than invasive cancer (odds ratio 1·0, 95 per cent confidence interval 0·8 to 1·3). NHG and NPI were not helpful in determining risk of local recurrence.
Conclusion
Margin status, age, tumour multicentricity, and use of radiotherapy and adjuvant hormone therapy were important determinants of risk of local recurrence. With the exception of surgical margin, variables related to the quality of surgical management did not predict risk of local recurrence. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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