title: [Breast cancer relative survival after the first recurrence and related prognostic factors].
abstract: OBJECTIVE
  Information regarding the incidence and prognosis of women who have suffered a recurrence of breast cancer is very variable. The aim of the present study was to determine the incidence of locoregional (LR) and distant recurrence and the survival and its determining factors after first recurrence.
  
  
  METHODS
  We included all women resident in Guipuzkoa who were diagnosed with invasive, non-disseminated breast cancer during 1995 and 1996 identified via Guipuzkoa's Cancer Registry. Recurrences that occurred up to December 2004 were determined retrospectively and compared with the National Death Registry of 2007 to determine the mortality. Relative survival was calculated by the Hakulinen method.
  
  
  RESULTS
  Five hundred and sixty one women with tumours in stages I-III were included, 90% of whom were treated with conservative surgery+radiation therapy, or mastectomy. The median follow-up for recurrence was eight years, with 5,7% of these recurrences being LR and 23% distant metastases. The median follow-up after recurrence was 6,1 years for live patients and 1,04 years for dead ones. The three-year survival was 54% (95% CI: 0,31-0,78) after LR recurrence and 18% (95% CI: 0,09-0,28) after distant recurrence. Multivariate analysis showed that the factors that remained as independent predictors of survival after LR recurrence were time to recurrence, age and degree of differentiation of the initial tumour. Age, time to recurrence and nodal involvement were associated with survival after distant recurrence.
  
  
  CONCLUSIONS
  Women younger than 54 at initial diagnosis with short disease-free periods and poorly differentiated tumours with nodal involvement have worse prognosis, which should be taken into account when deciding the therapeutic strategy to be followed upon recurrence.
authors.affiliation: Hospital Donostia, Donostia-San Sebastián, España. cristina.sarasquetaeizaguirre@osakidetza.net
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarasqueta
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Camblor
authors.forename: Arantza
authors.initials: A
authors.lastname: Mendiola
authors.forename: Iñaki
authors.initials: I
authors.lastname: Martínez-Pueyo
authors.forename: Maria Jesús
authors.initials: MJ
authors.lastname: Michelena
authors.forename: Mikel
authors.initials: M
authors.lastname: Basterretxea
authors.forename: Javier
authors.initials: J
authors.lastname: Recio
authors.forename: Isabel
authors.initials: I
authors.lastname: Alvarez
authors.forename: Nerea
authors.initials: N
authors.lastname: Larrañaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult