Predisposing factors

Factors predisposing to local recurrence after breast cancer surgery include:

• positive axillary nodes at time of surgery:
  • it has been suggested that all patients with positive nodes at the time of initial surgery should have radiotherapy to the breast
  • this has no major benefit:
    • after breast conservation, local recurrence may be reduced but prognosis remains the same
    • after mastectomy, prognosis is actually worsened by local radiotherapy
• large initial tumour size
• multifocal tumour
• histological features:
  • positive margins within the resected specimen
  • lymphatic and vascular invasion
  • aggressive tumour