When can a second conservative approach be considered for ipsilateral breast tumour recurrence?

Oreste Gentilini, E. Botteri, N. Rotmensz, B. Santillo, N. Peradze, R. C. Saihum, M. Intra, A. Luini, V. Galimberti, A. Goldhirsch, U. Veronesi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Mastectomy is considered the treatment of choice in patients with ipsilateral breast tumour recurrence (IBTR) after breast-conserving surgery (BCS). Patients and methods: One hundred and sixty-one patients with invasive IBTR who underwent a second conservative approach were retrospectively evaluated in order to describe prognosis, determine predictive factors of outcome and select the subset of patients with the best local control. Results: Fifty-seven patients (35.4%) relapsed after IBTR. Thirty-four patients (21.1%) had further in-breast recurrences and four patients (2.5%) had skin relapses. Five years cumulative incidence of local relapse was 31.4%. Twenty-four patients (17.8%, 5 years cumulative incidence) died during the follow-up. At the multivariate analysis, recurrent tumour size >2 cm was found to affect local-disease-free survival [hazard ratio (HR): 2.8, 95% confidence interval (CI) 1.2-6.2], whereas Ki-67 ≥20% and time to relapse ≤48 months were associated with disease-free survival (HR: 1.7, 95% CI 1.0-3.1, and HR: 2.1, 95% CI 1.2-3.6, respectively). Absence of oestrogen receptors affected overall survival (HR: 2.5, 95% CI 1.1-6.0). Among 64 patients with recurrent tumour ≤2 cm and time to IBTR >48 months, eight (12.8%, 5 years cumulative incidence) had further local relapses. Conclusions: Some patients with IBTR might receive a second BCS, especially when a good local control can be estimated (small recurrent tumour, late relapse), also taking into account patients' preference.

Original languageEnglish
Pages (from-to)468-472
Number of pages5
JournalAnnals of Oncology
Volume18
Issue number3
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Breast tumour
  • Breast-conserving surgery
  • Ipsilateral breast tumour recurrence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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