The place of extensive surgery in locoregional recurrence and limited metastatic disease of breast cancer: preliminary results.

M Berlière,Ph Piette,L Fellah,F Lecouvet,V Lacroix,I Leconte,F P Duhoux,C Galant,L Taburiaux,B Lengele,D Bouziane

doi:10.1155/2015/782654

M Berlière, Ph Piette + Show 9 more

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https://doi.org/10.1155/2015/782654

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Abstract

The aims of this study were first to clearly define two different entities: locoregional recurrences and limited metastatic disease and secondly to evaluate the place of extensive surgery in these two types of recurrence. Material and Methods. Twenty-four patients were followed from June 2004 until May 2014. All patients underwent surgery but for 1 patient this surgery was stopped because the tumour was unresectable. Results. The median interval between surgery for the primary tumour and the locoregional recurrence or metastatic evolution was 129 months. Eight patients had pure nodal recurrences, 4 had nodal and muscular recurrences, 5 had muscular + skin recurrences, and 8 had metastatic evolution. Currently, all patients are still alive but 2 have liver metastases. Disease free survival was measured at 2 years and extrapolated at 5 years and was 92% at these two time points. No difference was observed for young or older women; limited metastatic evolution and locoregional recurrence exhibited the same disease free survival. Conclusion. Extensive surgery has a place in locoregional and limited metastatic breast cancer recurrences but this option must absolutely be integrated in the multidisciplinary strategy of therapeutic options and needs to be planned with a curative intent.

Highlights

Locoregional recurrences and limited metastatic disease represent a very complex challenge in the treatment of breast cancer
There is a big confusion between local recurrences, locoregional recurrences, new primary cancer, and limited metastatic disease
We performed our study on 24 consecutive patients followed from June 2004 to May 2014 for locoregional breast cancer or limited metastatic disease in our institution

Summary

Introduction

Locoregional recurrences and limited metastatic disease represent a very complex challenge in the treatment of breast cancer. There is a big confusion between local recurrences, locoregional recurrences, new primary cancer, and limited metastatic disease. 24 experts from the Maastricht Breast Cancer Endpoint Consensus Group [1] defined local recurrences, second primary breast cancer, locoregional recurrences, and metastatic disease. Local events are represented by events in the ipsilateral breast, the scar, and cutaneous nodes. These local recurrences are excluded from our study. Locoregional events concern ipsilateral nodes, axillary, infraclavicular, subclavicular, retropectoral, and internal mammary nodes (and muscle recurrences in the pectoralis major and pectoralis minor). Metastatic evolution, concern invasion of contralateral nodes and of the sternal bone

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