Abstract 262P
Background
Breast cancer recurrences are among the leading causes of deaths related to the progression of this malignancy. Over the years, a number of factors have been studied with an overarching aim of being able to prognose recurrent disease. However, many factors remain related to causes, predictors and pathways of recurrence development remain unknown. At the same time, no analyses have been reported on the level of adherence to medical standards (MS) and their relation to recurrence rate.
Methods
We retrospectively analysed data from patients with recurrent breast cancer (BC) treated at two Bulgarian centres - National Hospital of Oncology and Lozenets University Hospital. Data from primary BCs and recurrences were compared. The level of adherence to MS was assessed by a selection of the quality indicators (QIs) that are adopted by European Society of Breast Cancer Specialists (EUSOMA).
Results
We included 263 patients treated for local recurrence of BC between January 2012 and March 2020. Median age at the time of first diagnosis was 45,2 years old. The time interval between the primary tumour (PT) and recurrence was between 1 month to 36 years. Most PTs were in T1 stage - 68.8% (T1a - 1,5%, T1b – 49%, T1c – 18,3%), and only 0.8% of them were T3. The lymph nodes status was N0 in 52% of patients. Regional lymph nodes could not be assessed (Nx) in 11,4% of patients, leading to decrease levels of adherence to MS. 67,3% of relapsing patients had high oestrogen receptor (ER+) titres (≥50%). We reported HER2 − in 79,8% of patients with PT and in 85,2% of relapsing patients. ER+/PR+ and HER2− patients have higher risk of recurrence after 5 years, especially in patients with high ER titre. We assessed the level of adherence to MS using main QIs: 4a, 10a, 10b, 10c, 11a, 11c, 12, 13a and 13b. The results showed significant differences in the level of adherence to MS according to the patients' age, biological characteristics and clinical treatment.
Conclusions
Despite many efforts that are being made to improve the quality of BC care, it would be greatly improved if we could reduce recurrences. Knowledge of the characteristics, prognostic factors and the monitoring of level of adherence to MS for BC recurrence can aid in the development of treatment strategies and follow-up in these patients at risk of recurrence.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
V. Mitova.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.