CAUSES OF DEATH IN PATIENTS WITH STAGE 0-II BREAST CANCER.

Aim: To analyze the main causes of death in patients with stage 0-II breast cancer who undergo breast conserving surgery or radical mastectomy, and to establish the role of imaging surveillance protocols following breast cancer treatment. Material and methods: We conducted a retrospective medical record review between January 2005 and December 2012, when breast cancer was the primary cause of death for 113 inpatients.  All patients were admitted to the Oncology Clinic of the Iasi Regional Cancer Institute (IRCI), Romania. Patients were stratified by clinical stage 0, I and II, of which 33 (29.2%) patients were managed by breast conservation therapy and 80 (70.8%) underwent radical mastectomy. From the patient medical records all diagnostic imaging studies performed (ultrasound, radiography and computed tomography) were identified and analyzed according to a standard protocol for imaging the postoperative breast. Results: Bone, liver, lung, lymph nodes and local-regional recurrence were the most common sites for metastasis, while the most frequent cause of death were metastases to the liver, pleura, lung and brain. The time interval between recurrence and death ranged from 0-24 years among patients with one type of metastasis, and decreased to 0-3 years since the last recurrence for patients with multiple metastases. Conclusions: The current imaging protocol for monitoring the postoperative breast could be optimized to improve the prognosis and quality of life in patients with stage 0-II breast cancer.