Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec;18(4):386-93.
doi: 10.4048/jbc.2015.18.4.386. Epub 2015 Dec 23.

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Jun Hee Lee  1 , Se Kyung Lee  1 , Sung Min Park  1 , Jae Min Ryu  1 , Hyun June Paik  1 , Ha Woo Yi  1 , Soo Youn Bae  1 , Jeong Eon Lee  1 , Seok Won Kim  1 , Seok Jin Nam  1
Affiliations

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Jun Hee Lee et al. J Breast Cancer. 2015 Dec.

Abstract

Purpose: Few studies address independent prognostic factors after ipsilateral breast tumor recurrence (IBTR) following breast-conserving surgery (BCS). Locoregional recurrence is associated with distant metastases and increased mortality rates. Therefore anticipating prognoses after IBTR and evaluating risk factors for overall survival following a second salvage operation are important. We evaluated independent prognostic factors affecting overall survival after a second operation for IBTR.

Methods: We retrospectively identified 11,073 patients who underwent breast cancer surgery between November 1995 and December 2011. Locoregional recurrence occurred in 787 patients. Among them, IBTR developed in 165 patients selected for analysis. Excluding eight patients who refused further treatment, we analyzed 157 patients who underwent a second operation (partial mastectomy, 28 [17.8%]; total mastectomy, 129 [82.2%]) for IBTR. Excluding 26 patients with incomplete data, we evaluated the clinicopathol-ogical features influencing overall survival at the first and the second operation in the 131 patients who underwent a second operation.

Results: The median age of patients at the first operation was 43.6 years (range, 27-69 years). The median duration from the first to the second operation was 45.0 months (range, 2.5-164.6 months). The 5-year overall survival rate after IBTR was 87.1%. In the multivariable analyses, duration from the first to the second operation, histopathology, lymph node status, and adjuvant chemotherapy, radiotherapy, and endocrine therapy at the first operation were independent prognostic factors for overall survival. Positive estrogen receptor status and endocrine therapy at the second operation were also associated with increased overall survival following salvage operations for IBTR.

Conclusion: The time interval to IBTR following BCS is related to overall survival after salvage operation for IBTR and it is important to undergo optimal adjuvant treatments according to risk factors after the first operation because those risk factors affect overall survival for IBTR following BCS.

Keywords: Locoregional neoplasm recurrence; Mortality; Prognostic factors; Segmental mastectomy.

PubMed Disclaimer

Conflict of interest statement

CONFLICT OF INTEREST: The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. Consort diagram depicting the study selection process.
LRR=locoregional recurrence; BCS=breast-conserving surgery; IBTR=ipsilateral breast tumor recurrence; TM=total mastectomy; PM=partial mastectomy; op=operation.
Figure 2
Figure 2. Overall survival after salvage operation for ipsilateral breast tumor recurrence.
Figure 3
Figure 3. Overall survival according to second operation methods.
TM=total mastectomy; PM=partial mastectomy.
See this image and copyright information in PMC

References

    1. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–1241. - PubMed
    1. Arriagada R, Lê MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group. J Clin Oncol. 1996;14:1558–1564. - PubMed
    1. Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1995;333:1456–1461. - PubMed
    1. Lichter AS, Lippman ME, Danforth DN, Jr, d'Angelo T, Steinberg SM, deMoss E, et al. Mastectomy versus breast-conserving therapy in the treatment of stage I and II carcinoma of the breast: a randomized trial at the National Cancer Institute. J Clin Oncol. 1992;10:976–983. - PubMed
    1. van der Sangen MJ, Poortmans PM, Scheepers SW, Lemaire BM, van Berlo CL, Tjan-Heijnen VC, et al. Prognosis following local recurrence after breast conserving treatment in young women with early breast cancer. Eur J Surg Oncol. 2013;39:892–898. - PubMed

LinkOut - more resources