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Recurrence analysis in T4 breast cancer in the Netherlands : A population-based study

Bouwen, Inez (2024) Recurrence analysis in T4 breast cancer in the Netherlands : A population-based study.

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Abstract:Background: Tumors of any size with direct extension to chest wall and/or to skin are classified as T4 breast cancer. Currently, there is limited information available on the occurrence of recurrences in T4 breast cancer. This population-based study aimed to analyze trends and risks of recurrence over time in patients with nonmetastatic T4 breast cancer in the Netherlands. Methods: All patients with nonmetastatic cT4 breast cancer between 2005-2008 and 2012-2016 in the Netherlands were selected. Patient-, tumor-, and treatment related characteristics were compared over time and between T4 subcategories. Locoregional recurrences were analyzed over a 5-year follow-up using Kaplan-Meier curves and Cox proportional hazard regression to estimate hazard ratios, accounting for confounders and considering competing risks. Results: 3,659 patients were diagnosed with cT4 breast cancer between 2005-2008 and 2012-2016: 1,654 (45.2%) in 2005-2008, and 2,005 (54.8%) in 2012-2016. Among the total population at risk of a recurrence (2,339 patients), 7.4% (155 patients) experienced a locoregional recurrence (LRR) within 5 years after their last surgery. The LRR rate decreased from 9.9% in 2005-2008 to 5.7% in 2012-2016. T4d shows the highest LRR rate of 11.4%, compared to 3.8% in T4ns, T4a, and T4c, and 5.9% in T4b. Clinical tumor stage, differentiation grade, multifocality, receptor subtype, and trimodal therapy were showed to be significant prognostic factors for the five-year RFS. Conclusion: These findings provide valuable insights into the trends and risks of locoregional recurrence in nonmetastatic T4 breast cancer. Understanding these trends and risk factors can support patient-tailored treatments and individualized follow-up strategies.
Item Type:Essay (Master)
Clients:
Integraal Kankercentrum Nederland (IKNL), Nederland
Faculty:TNW: Science and Technology
Programme:Health Sciences MSc (66851)
Link to this item:https://purl.utwente.nl/essays/100387
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