Analysis of prognostic and predictive factors of isolated chest wall recurrence in breast cancer after mastectomy

Objective: To investigate the clinical features, molecular subtypes, and factors influencing metastasis in patients with breast cancer chest wall metastasis. Methods: We collected the clinical data of patients who developed isolated chest wall metastasis following radical surgery for breast cancer. The molecular subtypes of the primary lesions and secondary biopsy lesions in patients with chest wall metastasis were analyzed and summarized. The disease-free survival (DFS) after breast cancer surgery and its influencing factors were also documented. Results: Of the 99 cases of isolated chest wall recurrence included in our study, DFS varied from 1 to 264 months, with a median DFS of 36 months. The 3-year disease-free survival rate was 44.6%, while the 5-year rate was 24.2%. Molecular subtype changes occurred in a total of 28 cases before and after metastasis, accounting for 34% of the cases. COX multivariate analysis revealed that pathological type, surgical staging, postoperative expression status of ER (estrogen receptor), PR (progesterone receptor), Ki-67, HER-2 (human epidermal growth factor receptor-2), and the receipt of adjuvant chemotherapy after surgery were independent factors affecting chest wall recurrence and metastasis. Conclusion: Local recurrence after breast cancer surgery increases the risk of distant metastasis. Identifying high-risk factors for recurrence enables the tailoring of individualized comprehensive treatment plans based on the patient's condition, thus reducing the risk of local recurrence and improving survival outcomes.