Risk Factors for Locoregional Recurrence Following Mastectomy for Localized Breast Cancer in a Nigerian Teaching Hospital

Abstract

Background: Mastectomy is an integral part of the management of breast cancer, especially in resource-limited centers. This study aimed to describe the outcomes in terms of locoregional recurrence (LRR) and distant metastasis (DM) after modified radical mastectomy (MRM) for breast cancer and factors associated with them. Methods: This was a retrospective study of patients who underwent mastectomy between October 2012 and September 2017. Data generated were analyzed using SPSS version 23.0. The results were presented using descriptive statistics. Inferential statistics was done using the chi-square test with statistical significance set at p <0.05. Results: Sixty-three (88.7%) of 71 patients who had MRM over the study period were eligible. Their ages ranged from 24-80 years with a median of 49 years (IQR, 43-59years). Lump size ranged from 2-18 cm (mean, 7.8±3.5 cm) and the lump duration was 1-48 months (median 6.0, IQR, 4.0-10.0 months). Sixteen (25.4%) patients developed LRR. The interval to occurrence of LRR after mastectomy ranged from 4-36 months (median, 9 months, IQR, 6.0-20.0). Eighteen (28.6%) patients developed distant metastasis 9-60 months after surgery (median 19, IQR 12.0-37.0 months) and 50% of those with LRR were among. Metastasis mostly affected the lungs and pleura in 55.6%. Mean tumour size ≥10cm (p <0.000), mean lump duration >11months, advanced disease T3/4 (p=0.01) and higher number of positive lymph nodes (p=0.011) were significantly associated with LRR. Both tumour size (p=0.01) and positive lymph nodes (p=0.015) are predictors of LRR. Conclusion: LRR and metastasis are common occurrences after mastectomy. Early presentation and availability of more adjuvant therapies can reduce the rate.