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
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