الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Recurrence of breast cancer following surgery is not uncommon, it can be loco-regional or distant. The most common tumor recurrence among breast cancer patients is distant recurrence, which constitutes more than 60% of all recurrences.
There are several factors associated with development of distant metastasis in the initially diagnosed early breast cancer. The following are established breast cancer prognostic markers for development of distant metastasis; tumor size, axillary nodal status, tumor grade, lympho-vascular invasion, HER2/neu overexpression and steroid receptor expression. Others are recent prognostic markers such as uPA/PAI protein levels and gene expression profiling.
The present work was carried out retrospectively to review the clinico-pathologic features of breast cancer patients who developed metastasis either during treatment or after completion of treatment, and to identify factors affecting survival and outcomes in this population.
To achieve this aim, the present study included 102 patients who developed metastasis during or after treatment of primary breast cancer. These patients presented to the Department of Surgical oncology and/or Clinical Oncology and Nuclear Medicine of Alexandria Main University Hospital during 4 years’ period from January 2014 to December 2017.
All medical records were reviewed and data about clinicopathological findings, and details of treatment received were retrieved and tabulated. Outcomes in terms of disease free survival and overall survival were estimated for 102 patients with sufficient data in their files. The following variables were correlated to survival on univariate analysis: age, menopausal status, BMI, tumor histology type, tumor grade, tumor hormonal receptor status, lymph node status and presence of lymph nodes involvement and number of positive lymph nodes.
Survival outcomes were analyzed for all the patients in the study who had complete data in their files and received treatments in Alexandria university Hospital. The median DFS after surgery was 17.9 months, while the median OS was 37.9 months.
Univariate analysis of factors found to have negative effect on DFS were larger tumor size, higher grade tumors, equal or more than 4 number of positive axillary nodes and negative ER/PR status. All the variables with P value of less than 0.5 on univariate analysis for DFS were further analyzed using multivariate analysis and factors found to be significant were tumor grade and number of positive lymph nodes.
Univariate analysis factors found to have negative affect on OS were younger age at diagnosis, larger tumor size, higher grade tumors and HER2 positive status. All the variables with P value of less than 0.5 on univariate analysis for OS were further analyzed using multivariate analysis and were all found to be significant.
This study points out different clinical and pathological prognostic factors have a considerable impact on the developments of metastasis and survival outcomes