| Summary: | Background : Breast cancer emerges as the highest incident cancer in Indonesia.
Mortality of breast cancer reaches up to 19,750 of 48,998 cases (40.31%) in 2012.
Locoregional recurrence usually develops 2-3 year after operation. Recurrence
incidence rate in Indonesia is very high affecting 20.2% of total breast cancer
cases. Several factors are identified to play a role in the breast cancer recurrence,
including age, tumor size, tumor stadium, lymph nodes status, histopathology
grade, estrogen receptor, progesterone receptor, and HER-2/neu
immunohistochemical subtypes.
Objective: To identify the most recent variables involved in the locoregional
recurrence of operable breast cancer after modified radical mastectomy and
adjuvant chemotherapy.
Subject: Patients with operable breast cancer who underwent a modified radical
mastectomy in Dr Sardjito hospital on January until December 2010 and met the
inclusion criteria.
Methods: We used descriptive non-experimental study with a retrospective
cohort design involving 109 patients with operable breast cancer treated in Dr
Sardjito hospital Januari-December 2010. Chi-square test and multivariate
analysis with logistic regression were used to determine clinicopathologic factors
involved in the high recurrence rate of breast cancer in Indonesia.
Results: In our cohort, we identified locoregional recurrence in 18 of 109 breast
cancer patients (16.51%). Clinicopathologic factors that significantly affect the
incidence of recurrence were tumor stadium (Breast cancer stadium IIIB vs IIIA,
p=0,006, OR 2,62). Tumor grade (grade 1 vs grade 3, p=0,039, OR 3,6), and
Her2/neu (Positive vs negative, p=0,037, OR 0,22). In addition, subtype of breast
cancer using immunohistochemitry showed that triple negative increased
recurrence rate in comparison to luminal B (p=0,009, OR 4,2). Multivariate
analysis using logistic regression showed that immunohistochemical subtype was
the most dominant factor influencing recurrence rate (p=0,041), particulary in
triple negative breast cancer (p=0,047).
Conclusion: In our study, clinicopathological variables affecting locoregional
recurrence of breast cancer were tumor stadium, histopathological grading, and
HER-2/neu immunohistochemical subtypes. The most dominant factor affecting
the incidence of recurrence was subtype of immunohistochemistry (triple
negative
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