Osmani F, et al. - In this population-based cohort study, researchers investigated prognostic factors related to two types of relapses of breast neoplasms. They used multivariate statistical models to determine the link between two possible relapses for the raised incidence of distant metastases seen in patients with local relapses injuries. This study was designed as a single-center and involved 1,815 patients suffering from breast cancer having age of 22 or more. By joint modeling of three correlated results: local recurrence, distant recurrence (metastasis) and death, the analysis of recurrence and survival were considered. A raised risk of local and metastatic relapses or death was observed for patients with at least one positive lymph node (N+) or for those with a grade greater than I, as per achieved results of the fitted models. A significant link of the variable HR+ with the hazards of locoronal, metastatic recurrence and death was observed for both reduced and proposed models. Experts inferred that significant information may be lost by not considering the link between these outcomes. Exercising caution while considering these findings is recommended, given the small number of recurrent events.