Abstract

PurposeThe purpose of this study was to investigate the clinicopathologic features and prognostic factors affecting outcome in patients with isolated locoregional recurrence of breast cancer (ILRR).MethodsWe retrospectively analyzed the medical records of 104 patients who were diagnosed with ILRR and underwent curative surgery from January 2000 to December 2010 at Samsung Medical Center.ResultsAmong 104 patients, 43 (41%) underwent total mastectomy and 61 (59%) underwent breast-conserving surgery for primary breast cancer. The median time from initial operation to ILRR was 35.7 months (4.5–132.3 months). After diagnosis of ILRR, 45 (43%) patients were treated with mastectomy, 41 (39%) with excision of recurred lesion, and 18 (17%) with node dissection. During a median follow-up of 8.9 years, the 5-year overall survival was 77% and 5-year distant metastasis-free survival (DMFS) was 54%. On multivariate analysis, younger age (< 35 years), higher stage, early onset of elapse (≤ 24 months), lymph node recurrences, and subtype of triple negative breast cancer (TNBC) were found to be independently associated with DMFS. Patients in the no chemotherapy group showed a longer DMFS after surgery for ILRR than those treated with chemotherapy (median 101.5 vs. 48.0 months, p = 0.072) but without statistical significance.ConclusionOur analysis showed that younger age (< 35 years), higher stage, early onset of relapse (≤ 24 months), lymph node recurrence, and subtype of TNBC are the worst prognostic factors for ILRR.

Highlights

  • Isolated locoregional recurrence (ILRR) of breast cancer after breast-conserving surgery (BCS) or mastectomy is associated with an increased risk of distant metastases and a poor prognosis [1,2,3,4,5,6]

  • After diagnosis of ILRR, 45 (43%) patients were treated with mastectomy, 41 (39%) with excision of recurred lesion, and 18 (17%) with node dissection

  • Patients in the no chemotherapy group showed a longer distant metastasis-free survival (DMFS) after surgery for ILRR than those treated with chemotherapy but without statistical significance

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Summary

Introduction

Isolated locoregional recurrence (ILRR) of breast cancer after breast-conserving surgery (BCS) or mastectomy is associated with an increased risk of distant metastases and a poor prognosis [1,2,3,4,5,6]. Salvage mastectomy has been the predominant local treatment modality for most patients with operable ILRR but second BCS might be considered in some patients, those with small and late recurrence [9,10,11]. These patients are regarded candidates for subsequent adjuvant systemic treatments with curative intent.

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