Clinical SurgeryPredictors of 5-year local, regional, and distant recurrent events in a population-based cohort of breast cancer patients

•We measured rates of local, region, and distant recurrence 5 years after breast cancer diagnosis.•Local, regional, and distant metastasis rates were very low in our cohort.•Surgeon volume, specialty, and practice type were not related to breast cancer recurrence.•Tumor factors such as size, grade, lymphovascular invasion, and nodal status predicted recurrence.

BackgroundThe 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.MethodsConsecutive 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.ResultsMedian 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.ConclusionTumor factors such as size, grade, lymphovascular invasion, and nodal status predicted BC recurrence, while practice type, surgeon specialty, and case volume did not.