An overview of risk factors for recurrent breast cancer.

The multidisciplinary management of Breast Cancer (BC) has evolved over the past 50 years: the patient is offered a choice of surgical procedures with or without radiation therapy, cytotoxics and treatments targeting the nuclei of the cancer cells. This has resulted in a reduction of disease recurrence and a significant increase in 5-year survival. But these good results deteriorate over time and almost 20% women with early stage, oestrogen-receptor (ER) positive BC will suffer recurrent cancer at 10 years. The aim of this review is the identification of risk factors for the recurrence of BC, to examine pathogenic pathways leading to BC and to report on modifications to lifestyle, surgical procedures and treatment regimes which can reduce the recurrence of BC. Patient factors associated with increased risk included the extremes of age, ethnicity, genetic inheritance obesity and alcohol ingestion. Human Immunodeficiency Virus (HIV) was not identified as a cause of BC. Treatment-related factors included microscopically positive excision margins, delay in initiation of adjuvant chemoradiation and lack of compliance with endocrine therapy. Reclassifying BC according to molecular subgroups more accurately identifies patients at risk for recurrence and aids in the appropriate selection of therapy targeted to the primary and lymphatic metastases.