Annals of Oncology Advance Access published online on December 8, 2006
Annals of Oncology, doi:10.1093/annonc/mdl424
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
When can a second conservative approach be considered for ipsilateral breast tumour recurrence?
1 Division of Breast Surgery, European Institute of Oncology, Milan, Italy
2 Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
3 Department of Medical Oncology, European Institute of Oncology, Milan, Italy
4 Scientific Director, European Institute of Oncology, Milan, Italy
*Correspondence to: Dr O. Gentilini, Division of Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. Tel: +39-02-57489376; Fax: +39-02-57489780; E-mail: oreste.gentilini{at}ieo.it
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.
breast-conserving surgery, breast tumour, ipsilateral breast tumour recurrence
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Botteri, V. Bagnardi, N. Rotmensz, O. Gentilini, D. Disalvatore, B. Bazolli, A. Luini, and U. Veronesi Analysis of local and regional recurrences in breast cancer after conservative surgery Ann. Onc., October 15, 2009; (2009) mdp386v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Botteri, N. Rotmensz, C. Sangalli, A. Toesca, N. Peradze, H. R. De Oliveira Filho, A. Sagona, M. Intra, P. Veronesi, V. Galimberti, et al. Unavoidable mastectomy for ipsilateral breast tumour recurrence after conservative surgery: patient outcome Ann. Onc., June 1, 2009; 20(6): 1008 - 1012. [Abstract] [Full Text] [PDF]
|
|