The significance of the site of recurrence to subsequent breast cancer survival

Aim To investigate differences in the 3-year survival of patients with recurrent breast cancer dependent on recurrence site. Methods The study was a review of 294 patients from a breast cancer database, who were treated for operable breast cancer and subsequently developed a recurrence between 1989 and 2003. Patients were divided into four groups according to the site of first recurrence (local, lymph node, bone or visceral). Breast Cancer Specific Survival (BCSS) was compared using Kaplan–Meier life table analysis and the log rank test. Results Patient and tumour characteristics were comparable between the four groups. Survival rates between the recurrence site groups were significantly different. Patients in whom first recurrence was local had the best prognosis with a 3-year BCSS of 83% compared to 33% for patients with first node recurrence (p < 0.001), 23% for patients with first bone recurrence (p = 0.03) and 13% for patients with first visceral recurrence (p = 0.004). Conclusion Survival of patients with recurrent breast cancer is associated with the site of first recurrence. The prognosis from recurrence is progressively worse with local, regional, bone and visceral metastasis.