Abstract
BackgroundWe aimed to evaluate the differences in the rates and predictive factors for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) between ductal carcinoma in situ (DCIS) and invasive breast cancer. And, we evaluated the impact of IBTR on overall survival and distant metastasis.MethodsWe retrospectively reviewed 322 consecutive patients with DCIS or invasive breast cancer who underwent BCS between 2004 and 2010. We evaluated the rates of IBTR of DCIS and invasive breast cancer. Univariate and multivariate analyses were performed to determine the predictive factors for IBTR, and survival rates were analyzed with Kaplan-Meier estimates.ResultsWith a median follow-up period of 57 months, 5 (10 %) out of 50 DCIS patients and 14 (5.1 %) out of 272 invasive cancer patients had developed IBTR. Factors associated with IBTR on univariate and multivariate analyses were positive resection margin status in DCIS and omission of radiotherapy in invasive cancer, respectively. The hormone receptor negativity was strong independent predictive factors for IBTR in both DCIS and invasive breast cancer. Although the differences of survival curve did not reach statistical significance, the 5-year overall survival and distant metastasis-free survival of invasive cancer patients who suffered IBTR were inferior to those without (84 vs. 98 % and 63.3 vs. 96.5 %, respectively). Advanced initial stage, lymph node metastasis and experience of IBTR were associated with poor overall survival and distant metastasis on univariate and multivariate analyses.ConclusionsThe hormone receptor negativity was revealed as independent predictive factor for IBTR after BCS in both DCIS and invasive cancer. Experience of IBTR was independent prognostic factor for poor overall outcome in patients with invasive breast cancer. Aggressive local control and adjuvant therapy should be made in hormone receptor-negative patients who receive treatment with BCS.
Highlights
We aimed to evaluate the differences in the rates and predictive factors for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) between ductal carcinoma in situ (DCIS) and invasive breast cancer
The rationale for performing BCS is that the overall survival (OS) was not different compared to the mastectomy group
Radiation therapy was performed in 310 patients (96.3 %), and hormonal therapy was performed in 236 patients (73.3 %)
Summary
We aimed to evaluate the differences in the rates and predictive factors for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) between ductal carcinoma in situ (DCIS) and invasive breast cancer. The number of early breast cancer detections has increased due to the development of screening programs, and the rates of breast-conserving surgery (BCS) have increased. The results of 20 years of follow-up from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-06 trial showed no significant differences in disease-free survival, distant disease-free survival, or overall survival between the BCS and mastectomy groups [1]. The incidence of ipsilateral breast tumor recurrence (IBTR) after BCS is 5–10 % during 5 years of follow-up, and the risk continues over a longer period of follow-up [1, 2]. The rationale for performing BCS is that the overall survival (OS) was not different compared to the mastectomy group
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