title: PREDICTORS OF INFLAMMATORY LOCAL RECURRENCE AFTER BREAST-CONSERVING THERAPY FOR BREAST CANCER: MATCHED CASE-CONTROL STUDY.
abstract: BACKGROUND
  Inflammatory local recurrence (ILR) after breast-conserving surgery for noninflammatory breast cancer (BC) is associated with dismal prognosis. Risk factors for ILR are not well defined.
  
  
  METHODS
  Between 2001 and 2010, twelve patients at our hospital developed ILR after breast-conserving surgery, adjuvant chemotherapy, and radiotherapy for BC. We compared their clinico-pathological characteristics to those of 24 patients with noninflammatory local recurrence (non-ILR), 24 patients with distant metastases, and 48 disease-free controls, matched for age and observation period.
  
  
  RESULTS
  The median time to ILR was 10 months. In univariate analysis, extent of lymph node involvement (p < 0.05), multifocality (p < 0.05), c-erbB2 overexpression (p < 0.05), and lymphovascular invasion (LVI) (p < 0.001) affected the risk of ILR. Conditional logistic regression analysis showed a significant association between ILR and combined LVI and high histopathological grade. The odds ratio (OR) for ILR versus non-ILR was 6.14 (95% confidence interval [CI] 1.48-25.38) and for ILR versus distant metastases it was 3.05 (95% CI 0.09-97.83) when both LVI and high histopathological grade were present. Patients with family history of BC were more likely to present with ILR than non-ILR (OR 5.47; 95% CI 1.55-19.31) or distant relapse (OR 5.62; 95% CI 0.26-119.95).
  
  
  CONCLUSIONS
  Pre- and postmenopausal women with high-grade BC and LVI are at increased risk to develop ILR, especially in the presence of family history of BC. Identification of risk factors for this lethal form of recurrent BC may lead to more effective preventive treatment strategies in properly selected patients.
authors.forename: Riad
authors.initials: R
authors.lastname: Akoum
authors.forename: Eddie K
authors.initials: EK
authors.lastname: Abdalla
authors.forename: Michel
authors.initials: M
authors.lastname: Saade
authors.forename: Adnan
authors.initials: A
authors.lastname: Awdeh
authors.forename: Fouad
authors.initials: F
authors.lastname: Abi-Aad
authors.forename: Noha
authors.initials: N
authors.lastname: Bejjani
authors.forename: Antoine
authors.initials: A
authors.lastname: Ghossain
authors.forename: Emile
authors.initials: E
authors.lastname: Brihi
authors.forename: Akram
authors.initials: A
authors.lastname: Audi
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008413:Mastitis / Q000453:epidemiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors