Risk Factors For Recurrence And Metastasis After Modified Radical Mastectomy

Objective: To explore the related risk factors of recurrence and metastasis after modified radical mastectomy,so as to provide reference for formulating more reasonable individualized treatment scheme and evaluating the prognosis of patients.Methods: Statistical analysis data of 222 patients admitted to the department of radiotherapy of the second affiliated hospital of dalian medical university from January2010 to December 2017 were complete.Collect patients age,menopausal status,tumor location,pathological type,histological grade,vascular tumor emboli and(or)nerve invasion,primary tumor size,T stage),the number of axillary lymph node metastasis(N staging),estrogen receptor(ER)and progesterone receptor(PR),its ehrs-2 receptor and molecular classification and other risk factors.Single factor analysis was performed for risk factors by chi-square test,and multivariate stepwise Logistic regression was used for multivariate analysis for positive risk factors.P value was calculated,and P <0.05 was considered statistically significant.Result:1.Among the 222 cases of postoperative recurrence and metastasis of breast cancer included in this study,68 cases had local recurrence and 96 cases had regional recurrence;Visceral metastasis occurred in 138 patients,bone metastasis in 106 patients,and central nervous system metastasis in 42 patients.2.Univariate analysis showed that tumor site,histological grade,tumor size,number of axillary lymph node metastases,ER and PR,and molecular typing were the influencing factors of postoperative local recurrence of breast cancer.Postoperativemenopausal status,vascular thrombi and/or nerve invasion,and different molecular types are the influencing factors for regional recurrence of breast cancer.Age of onset,postmenopausal status,tumor site,pathological type,histological grade,vascular thrombi and/or nerve invasion,tumor size and molecular typing are the influencing factors of postoperative visceral metastasis of breast cancer.Tumor site,pathological type,vascular thrombus and/or nerve invasion,number of axillary lymph node metastasis,ER,PR and molecular typing are the influencing factors of postoperative bone metastasis of breast cancer.Age of onset,vascular thrombus and/or nerve invasion,tumor size,number of axillary lymph node metastases,ER and PR status,and molecular typing are the influencing factors of central nervous system metastasis after breast cancer surgery.3.Multivariate analysis showed that the number of axillary lymph node metastases,histological grading and molecular typing were independent predictors of postoperative local recurrence of breast cancer.Age of onset,her-2 receptor,molecular typing,vascular thrombi and/or nerve involvement were independent predictors of regional recurrence after breast cancer surgery.Postmenopausal status,tumor location,pathological type,histological grade,molecular typing,vascular thrombi and/or nerve invasion were independent predictors of postoperative visceral metastasis in breast cancer.Pathological types and molecular typing were independent predictors of postoperative bone metastasis in breast cancer.Age of onset,tumor size and molecular typing were independent predictors of postoperative central nervous system metastasis in breast cancer.Conclusion:1.Breast cancer at age 35 or younger are prone to regional recurrence and central nervous system metastasis;Premenopausal breast cancer patients are more likely to have visceral metastasis;2.Breast cancer patients with invasive ductal carcinoma are more likely to have visceral metastasis and bone metastasis;Histological grading was positively correlated with visceral metastasis rate.Stage T4 breast cancer patients are more likely to havevisceral metastasis and central nervous system metastasis.3.ER positive breast cancer patients are more likely to have bone metastasis;Basal-like breast cancer patients are more prone to regional recurrence,visceral metastasis and central nervous system metastasis.