# Factors associated with recurrence in operable breast cancer patients undergoing surgery as the sole treatment modality

## TL;DR

This study identifies factors linked to breast cancer recurrence in patients treated with surgery alone, including HER2 amplification and pesticide exposure in young women.

## Contribution

The study highlights pesticide exposure as a novel regional risk factor for recurrence in young, premenopausal breast cancer patients.

## Key findings

- HER2 amplification and metastatic disease were associated with higher recurrence risk.
- Premenopausal women exposed to pesticides with triple-negative tumors had increased recurrence rates.
- Pesticide exposure emerged as a significant local factor in poor outcomes for breast cancer patients.

## Abstract

Approximately 10% of breast cancer patients with localized operable disease experience recurrence. This study aimed to evaluate patients with early-stage breast cancer (TNM I and II) who underwent surgery without the need for neoadjuvant therapy.

The total of 117 patients was included in the study: 104 without recurrence and 13 with recurrence. We analyzed various clinicopathological parameters, including body mass index, age at diagnosis, menopausal status, pesticide exposure, and tumor characteristics such as HER2 amplification, Ki67 index, molecular subtype, and histological grade.

Two primary subsets were identified as being associated with disease recurrence. The first subset (PC1) was characterized by HER2 amplification and metastatic disease, while the second subset (PC2) comprised premenopausal young women exposed to pesticides who had triple-negative tumors. While some of these factors are well-documented in the literature, pesticide exposure emerged as a notable regional factor contributing to poor outcomes in breast cancer patients.

These findings underscored the significance of identifying local and regional risk factors when assessing recurrence risk in women with breast cancer, particularly in cases in which surgery is the primary treatment approach.