Aim of the work:investigate  pattern  of  breast cancer recurrence and  the affecting factors on early  and late recurrence and identify factors affecting site specific recurrence.
Patients and methods:A retrospective study of  141 patients presented to   clinical oncology department ,sohag university hospital between January 2000 and  December 2014 diagnosed with invasive breast cancer.All of them underwent surgery either modified radical mastectomy,simple mastectomy or breast conservative surgery then received adjuvant systemic therapyeitherchemotherapy,endocrine therapy or both.Adjuvant radiotherapy was given when indicated.This study was conducted by hand search in the files.
Results:90%(n=127) of our patients develop recurrence in first 5 year with 64.5%(n=91) of  total number of patient in first 3 year. Patients still have risk of recurrence even after 10 years after  primary treatment as 2 patients  develop  recurrence after 10 years. Among 141 patients with recurrence, 116 patients (82.2%) and 32 (22.6%) were involved with distant and loco regional recurrence, respectively.The most prevalent distant metastasis was seen in bone  with liver , lung and brain metastasis in descending manner. Multiple organ metastasis was detected in 36% of patients.
In our study in early recurrence group  70% (n=89) had  tumor size more than 2 cm ,88%(n=113) had positive  axillary lymph node ,98%(n=125) had high tumor grade indicate that tumor size larger than 2 cm, axillary lymph node involvement ,high tumor grade  tend to be important prognostic factors in early recurrence.
The present study has demonstrated  that there is no significant tumor or patient characteristic  associated with the site-specific risks of metastasis.
Conclusion:Most breast cancer recurrence occur  during first 5 year with peakincidence  in1and  2year.Tumor size larger than2cm, lymph node involvement and high tumor grade tend to be important prognostic factors in early recurrence before 5 year. The most common exclusive first site of metastasis was bone and the least common is the brain.The current clinical practice of screening for site specific metastatic disease based on concerning patient specific signs or symptoms is supported.