The aim of this study was to establish whether local relapse after conservative surgery represents a failure of local control without affecting overall survival (OS) or if it is related with a worst prognosis and represents a failure of the treatment. Patients and methods: 2537 patients conservatively treated for primary breast cancer were followed up for a median of 18 years. OS of 233 patients which developed a local relapse as first event (FLR) was compared with OS of the remaining 2304. OS was calculated from the date of primary surgery for both groups and included all cases of death. Differences on the occurrence of death within the two groups were assessed by means of log-rank test. Results: We did not find any statistically significant difference between the two groups (patients who recurred locally vs patients with no history of FLR) in terms of OS. Also subgroups analysis (i.e. age, nodal status, and adjuvant systemic treatment) failed to show any difference. However when patients in which treatment failed locally have been considered alone with regard to time to FLR, a progressive decrease in survival was observed and patients who recurred after 60 months showed the best survival. Conclusion: Long term follow up highlights that FLR is a local control failure which did not entail a worse prognosis when effective treatment is performed for primary tumour. Our results suggest that early FLRs seem to be an expression of combined treatment resistance, therefore they require an aggressive rescue therapy. Combined treatment after FLR should follow the guidelines adopted for primary breast cancer if the time to FLR is longer than 24 months. A better definition of the biological characteristic of primary tumour will allow a combined therapy modulated by prognostic and predictive factors improving local control and survival for patients with breast cancer.
|Number of pages||1|
|Journal||Breast Cancer Research and Treatment|
|Publication status||Published - 2001|
ASJC Scopus subject areas
- Cancer Research