title: Predictors of 5-year local, regional, and distant recurrent events in a population-based cohort of breast cancer patients.
abstract: BACKGROUND
  The study purpose was to identify tumor and surgeon predictors of local recurrence (LR), regional recurrence (RR), and distant metastasis (DM) after breast cancer (BC) surgery in a population-based cohort.
  
  
  METHODS
  Consecutive BC surgical cases from 12 hospitals in South Central Ontario between May 2006 and October 2006 were included. Data collected on chart review included patient and tumor factors, surgery type, adjuvant treatment, surgeon specialty, surgeon case volume, and practice type. Univariate and multivariable survival analyses were performed.
  
  
  RESULTS
  Median follow-up was 5.5 years for 402 patients (97% of sample). LR, RR, and DM occurred in 18 (4.5%), 10 (2.5%), and 47 (12%) patients, respectively. Significant predictors of BC recurrence (LR or RR or DM) were tumor size and grade, nodal status, and lymphovascular invasion on multivariable analysis.
  
  
  CONCLUSIONS
  Tumor factors such as size, grade, lymphovascular invasion, and nodal status predicted BC recurrence, while practice type, surgeon specialty, and case volume did not.
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.
authors.forename: Filgen
authors.initials: F
authors.lastname: Fung
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.
authors.forename: Sylvie D
authors.initials: SD
authors.lastname: Cornacchi
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University and Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
authors.forename: Thuva
authors.initials: T
authors.lastname: Vanniyasingam
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada.
authors.forename: Dyda
authors.initials: D
authors.lastname: Dao
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University and Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; Department of Surgical Oncology, Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada.
authors.forename: Marko
authors.initials: M
authors.lastname: Simunovic
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; Department of Surgical Oncology, Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hodgson
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: O'Brien
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; Department of Surgical Oncology, Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Reid
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; Department of Surgical Oncology, Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada.
authors.forename: Barbara
authors.initials: B
authors.lastname: Heller
authors.affiliation: Department of Surgery, McMaster University, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N 4A6, Canada; Department of Surgical Oncology, Hamilton Health Sciences, Juravinski Hospital and Cancer Centre, 699 Concession Street, Hamilton, Ontario, L8V 5C2, Canada. Electronic address: lovricsp@mcmaster.ca.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Lovrics
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000706:statistics & numerical data; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009864:Ontario / Q000453:epidemiology; D011365:Professional Practice Location / Q000706:statistics & numerical data; D013043:Specialties, Surgical / Q000706:statistics & numerical data
keywords: Breast cancer-specific mortality; Breast conserving surgery; Mastectomy; Surgeon specialty; Surgeon volume