Abstract
Background. Mastectomy is still considered the treatment of first choice in patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) and whole-breast radiotherapy. Methods. We retrospectively evaluated 161 patients with invasive IBTR who underwent a second BCS in order to describe prognosis, determine predictive factors of outcome, and select the subset of patients with the best local control. Median follow-up after IBTR was 81 months. Results. Median age at IBTR was 53 years. Five-year overall survival after IBTR was 84 % (95 % confidence interval [CI] 78-89). Five-year cumulative incidence of a second local event after IBTR was 29 % (95 % CI 22-37). At the multivariate analysis, IBTR size>2 cm and time to relapse ≤48 months significantly increased the risk of local reappearance (hazard ratio [HR] 3.3, 95 % CI 1.6-7.0; and HR 1.9, 95 % CI 1.1-3.5). The 5-year cumulative incidence of a further local reappearance of the tumor after repeating BCS was 15.2 % in the patients with IBTR ≤2 cm and time to IBTR >48 months, 31.2 % in the patients with IBTR ≤2 cm and time to IBTR ≤48 months, and 71.2 % in patients with IBTR>2 cm (P48 months) IBTR. The information about the risk of a further local reappearance after repeating BCS should be shared with the patients in the decision making process.
| Original language | English |
|---|---|
| Pages (from-to) | 3771-3776 |
| Number of pages | 6 |
| Journal | Annals of Surgical Oncology |
| Volume | 19 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Nov 2012 |
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ASJC Scopus subject areas
- Surgery
- Oncology
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Repeating conservative surgery after ipsilateral breast tumor reappearance : Criteria for selecting the best candidates. / Gentilini, Oreste; Botteri, Edoardo; Veronesi, Paolo; Sangalli, Claudia; Del Castillo, Andres; Ballardini, Bettina; Galimberti, Viviana; Rietjens, Mario; Colleoni, Marco; Luini, Alberto; Veronesi, Umberto.
In: Annals of Surgical Oncology, Vol. 19, No. 12, 11.2012, p. 3771-3776.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Repeating conservative surgery after ipsilateral breast tumor reappearance
T2 - Criteria for selecting the best candidates
AU - Gentilini, Oreste
AU - Botteri, Edoardo
AU - Veronesi, Paolo
AU - Sangalli, Claudia
AU - Del Castillo, Andres
AU - Ballardini, Bettina
AU - Galimberti, Viviana
AU - Rietjens, Mario
AU - Colleoni, Marco
AU - Luini, Alberto
AU - Veronesi, Umberto
PY - 2012/11
Y1 - 2012/11
N2 - Background. Mastectomy is still considered the treatment of first choice in patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) and whole-breast radiotherapy. Methods. We retrospectively evaluated 161 patients with invasive IBTR who underwent a second BCS in order to describe prognosis, determine predictive factors of outcome, and select the subset of patients with the best local control. Median follow-up after IBTR was 81 months. Results. Median age at IBTR was 53 years. Five-year overall survival after IBTR was 84 % (95 % confidence interval [CI] 78-89). Five-year cumulative incidence of a second local event after IBTR was 29 % (95 % CI 22-37). At the multivariate analysis, IBTR size>2 cm and time to relapse ≤48 months significantly increased the risk of local reappearance (hazard ratio [HR] 3.3, 95 % CI 1.6-7.0; and HR 1.9, 95 % CI 1.1-3.5). The 5-year cumulative incidence of a further local reappearance of the tumor after repeating BCS was 15.2 % in the patients with IBTR ≤2 cm and time to IBTR >48 months, 31.2 % in the patients with IBTR ≤2 cm and time to IBTR ≤48 months, and 71.2 % in patients with IBTR>2 cm (P48 months) IBTR. The information about the risk of a further local reappearance after repeating BCS should be shared with the patients in the decision making process.
AB - Background. Mastectomy is still considered the treatment of first choice in patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) and whole-breast radiotherapy. Methods. We retrospectively evaluated 161 patients with invasive IBTR who underwent a second BCS in order to describe prognosis, determine predictive factors of outcome, and select the subset of patients with the best local control. Median follow-up after IBTR was 81 months. Results. Median age at IBTR was 53 years. Five-year overall survival after IBTR was 84 % (95 % confidence interval [CI] 78-89). Five-year cumulative incidence of a second local event after IBTR was 29 % (95 % CI 22-37). At the multivariate analysis, IBTR size>2 cm and time to relapse ≤48 months significantly increased the risk of local reappearance (hazard ratio [HR] 3.3, 95 % CI 1.6-7.0; and HR 1.9, 95 % CI 1.1-3.5). The 5-year cumulative incidence of a further local reappearance of the tumor after repeating BCS was 15.2 % in the patients with IBTR ≤2 cm and time to IBTR >48 months, 31.2 % in the patients with IBTR ≤2 cm and time to IBTR ≤48 months, and 71.2 % in patients with IBTR>2 cm (P48 months) IBTR. The information about the risk of a further local reappearance after repeating BCS should be shared with the patients in the decision making process.
UR - http://www.scopus.com/inward/record.url?scp=84868145598&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868145598&partnerID=8YFLogxK
U2 - 10.1245/s10434-012-2404-5
DO - 10.1245/s10434-012-2404-5
M3 - Article
C2 - 22618719
AN - SCOPUS:84868145598
VL - 19
SP - 3771
EP - 3776
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 12
ER -