Postmastectomy locoregional recurrence and distant metastasis in breast carcinoma patients

The aim of this study was to investigate predictive factors related to distant recurrence (DR) and to determine whether an association exists between locoregional recurrence (LRR) and DR in 956 patients. The multivariate time-dependent Cox regression analysis showed that tumor size (>2 cm vs ≤2 cm; p < 0.0001; Hazard Ratio [HR], 3.7; 95% Confidence Interval [CI], 2.2–6.0), pN status (pN2/3 vs pN1; p < 0.0001; HR, 2.3; 95%CI, 1.7–3.1), lymphatic vascular involvement (yes vs no; p = 0.001; HR, 1.7; 95%CI, 1.2–2.3) and LRR (yes vs no; p = 0.001; HR, dependent on time) were the important prognostic factors for DR. This study confirms a time-dependent association between LRR and DR. A DR occurred immediately after LRR is strongly associated with the LRR, but this association decreases over time, and therefore, a DR occurred lately after LRR is, possibly, not related to this LRR.