Clinico-morphological and molecular-biological risk factors for breast cancer recurrence

Objective: To study the nature and frequency of breast cancer recurrence, taking into account the clinical, morphological and molecular biological characteristics of the tumor. Materials and Methods: A comparative analysis of data from 208 breast cancer patients was conducted, divided into two groups: a study group (104 patients with verified recurrence) and a control group (104 patients with no signs of recurrence over a follow-up period of >=5 years). The analysis included a detailed examination of parameters such as age, menstrual status, tumor histology, TNM stage, grade of differentiation (G), and molecular subtypes (ER, RP, HER2, and Ki-67). Results: The average age in the relapse group was 48.7 years, while in the control group it was 50.1 years. In the control group, there was a significant predominance of patients aged 50-59 years (55.8% versus 37.5%; p<0.001). In the relapse group, locally advanced stages (IIIA-IIIC - 66.3%) and metastatic stages (IV - 10.6%) were diagnosed more often. Poorly differentiated tumors were also detected significantly more often (G3: 41.3% versus 14.4%, p<0.001). Analysis of molecular subtypes revealed that aggressive forms of breast cancer were more common in the study group: luminal B HER2-negative (40.4%), HER2+ non-luminal (12.5%), and triple-negative breast cancer (10.6%). In the control group, luminal A subtype predominated (43.3%; p<0.001). Histological tumor type and menopausal status did not independently influence prognosis. Conclusion: The risk of breast cancer recurrence depends on many factors. The most important are the extent of the disease at advanced stages (III-IV), low cell differentiation (G3), aggressive molecular subtypes (HER2 and triple-negative), and young patient age. These data justify the need for personalized risk stratification to optimize adjuvant therapy strategies.