A cross-sectional study on the pattern of recurrence in carcinoma breast patients based on molecular subtypes

Background: Breast cancer is a major public health issue and it is the leading cause of cancer related death in females worldwide. New insights in the cancer treatment led to considerable improvement in the survival of cancer patients. But metastasis remain an area were all sorts of conventional treatments fails and it is the cause of death of most carcinoma breast patients. In this study we aim to establish a possible link to local recurrence and distant metastasis with different biological subtypes of breast cancer.Methods: One hundred and eighty patients of carcinoma breast patients of carcinoma breast who presented with local recurrence or distant metastasis in the period of January 2018 to March 2019 in Government Medical College, Thiruvananthapuram were included in this study. These data were collected from the hospital records.Results: Local recurrence was most seen in triple negative (50%) subtype followed by HER2 (32.1%) enriched. Local recurrence was least among luminal A (13.8%) with a p value of 0.001. Bone metastasis was the most common type of metastasis and was most seen in luminal A (p=0.001). Triple negative had the maximum CNS metastasis with a p value of 0.003. Liver metastasis was seen mostly in luminal B (26.2%) and A (20.7%) and lung metastasis in triple negative (13.5%) and HER2/neu (10.7%). However, there was no significant association for lung or liver metastasis to any subtype.Conclusions: Biological subtypes of breast cancer classified by immunohistochemical expression of ER, PR, HER2, Ki 67 show different clinicopathological features, recurrence pattern, and survival outcomes.