title: Histologic multifocality is predictive of skin recurrences after conserving treatment of stage I and II breast cancers.
abstract: OBJECTIVE
  To distinguish various types of local recurrence after conserving treatment of breast cancer and to evaluate their predictive value.
  
  
  METHODS
  We first researched the pronostic factors after local recurrence and second evaluated the predictive factors of skin and inflammatory recurrences out of a series of 605 cases of stage I and stage II breast cancer of less than 4 cm in diameter that occurred after conserving treatment.
  
  
  RESULTS
  Multivariate analysis revealed two major predictors of poor prognosis associated with recurrence: early appearance Hazard ratio 3.0 (1.28-7.00) (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 metastasis by 2.6. This result depended on the type of recurrence: when those with inflammatory and cutaneous types were excluded, local recurrence was no longer a poor prognostic factor. Patients who experienced primary invasive tumor with histologic multifocality have a 4.08 (1.44-11.59) (p < 0.004) times greater risk of developing cutaneous or inflammatory recurrences compared with patients who experienced breast cancer unique localization.
  
  
  CONCLUSIONS
  As histologic multifocality is the only factor predictive of dark prognosis local breast cancer recurrences, aggressive therapy at the time of the primary treatment could be the therapeutic implications of such finding on the original tumor.
authors.affiliation: Department of Gynaecology and Obstetrics, Hopital Bretonneau, Tours, France.
authors.forename: H
authors.initials: H
authors.lastname: Marret
authors.forename: F
authors.initials: F
authors.lastname: Perrotin
authors.forename: P
authors.initials: P
authors.lastname: Bougnoux
authors.forename: B
authors.initials: B
authors.lastname: Giraudeau
authors.forename: B
authors.initials: B
authors.lastname: Hubert
authors.forename: F
authors.initials: F
authors.lastname: Fetissof
authors.forename: O
authors.initials: O
authors.lastname: Le Floch
authors.forename: J
authors.initials: J
authors.lastname: Lansac
authors.forename: G
authors.initials: G
authors.lastname: Body
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000556:secondary; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000556:secondary; D018275:Carcinoma, Lobular / Q000556:secondary; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000556:secondary*; D016019:Survival Analysis