Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcome.

2.50
Hdl Handle:
http://hdl.handle.net/10541/78879
Title:
Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcome.
Authors:
McBain, Catherine A; Young, E A; Swindell, Ric; Magee, Brian; Stewart, Alan L
Abstract:
Local recurrence of cancer in the treated breast following breast-conserving surgery and radiotherapy occurs in a minority of patients, but can represent a significant clinical problem. The impact of local relapse on the subsequent course of the disease is disputed. The aim of this retrospective review was to identify the rate and prognostic factors for breast recurrence and to determine the subsequent outcome. The case notes of 2159 patients treated between 1989 and 1992 were reviewed. Actuarial local relapse rate was 6.3% at 5 years. Factors predictive for recurrence on multivariate analysis were age (P<0.001), status of excision margins (P=0.019), and pathological UICC stage (P=0.01). One hundred and sixty-one patients developed local recurrence in the treated breast of whom 101 were treated with further surgery. The 5-year cancer-specific survival of this group was comparable with that of the patients who remained free of breast relapse (82 vs. 88%) but subsequently fell to 61 vs. 80% at 8 years (P<0.001). Sixty patients were unable to have salvage surgery; their cancer-specific survival was much worse than that of patients with operable recurrences at 33% at 5 years and 13% at 8 years. Eighty-three patients (4% of the original 2159 patients) had uncontrolled local disease at time of death or last follow-up. The prognosis of patients who developed recurrence within 2 years of their initial treatment was inferior to those who developed recurrences after 4 years (cancer-specific survival 5 years post-recurrence 23 vs. 57% P=0.008). Systemic therapy should be considered for patients with early breast recurrence in view of their inferior survival.
Affiliation:
Department of Clinical Oncology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.
Citation:
Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcome. 2003, 15 (1):25-31 Clin Oncol
Journal:
Clinical Oncology
Issue Date:
Feb-2003
URI:
http://hdl.handle.net/10541/78879
DOI:
10.1053/clon.2002.0165
PubMed ID:
12602551
Type:
Article
Language:
en
ISSN:
0936-6555
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMcBain, Catherine A-
dc.contributor.authorYoung, E A-
dc.contributor.authorSwindell, Ric-
dc.contributor.authorMagee, Brian-
dc.contributor.authorStewart, Alan L-
dc.date.accessioned2009-08-27T11:29:58Z-
dc.date.available2009-08-27T11:29:58Z-
dc.date.issued2003-02-
dc.identifier.citationLocal recurrence of breast cancer following surgery and radiotherapy: incidence and outcome. 2003, 15 (1):25-31 Clin Oncolen
dc.identifier.issn0936-6555-
dc.identifier.pmid12602551-
dc.identifier.doi10.1053/clon.2002.0165-
dc.identifier.urihttp://hdl.handle.net/10541/78879-
dc.description.abstractLocal recurrence of cancer in the treated breast following breast-conserving surgery and radiotherapy occurs in a minority of patients, but can represent a significant clinical problem. The impact of local relapse on the subsequent course of the disease is disputed. The aim of this retrospective review was to identify the rate and prognostic factors for breast recurrence and to determine the subsequent outcome. The case notes of 2159 patients treated between 1989 and 1992 were reviewed. Actuarial local relapse rate was 6.3% at 5 years. Factors predictive for recurrence on multivariate analysis were age (P<0.001), status of excision margins (P=0.019), and pathological UICC stage (P=0.01). One hundred and sixty-one patients developed local recurrence in the treated breast of whom 101 were treated with further surgery. The 5-year cancer-specific survival of this group was comparable with that of the patients who remained free of breast relapse (82 vs. 88%) but subsequently fell to 61 vs. 80% at 8 years (P<0.001). Sixty patients were unable to have salvage surgery; their cancer-specific survival was much worse than that of patients with operable recurrences at 33% at 5 years and 13% at 8 years. Eighty-three patients (4% of the original 2159 patients) had uncontrolled local disease at time of death or last follow-up. The prognosis of patients who developed recurrence within 2 years of their initial treatment was inferior to those who developed recurrences after 4 years (cancer-specific survival 5 years post-recurrence 23 vs. 57% P=0.008). Systemic therapy should be considered for patients with early breast recurrence in view of their inferior survival.en
dc.language.isoenen
dc.subjectBreast Canceren
dc.subjectCancer Recurrenceen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshBreast Neoplasms-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshPrognosis-
dc.subject.meshRadiotherapy, Adjuvant-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshSurvival Analysis-
dc.titleLocal recurrence of breast cancer following surgery and radiotherapy: incidence and outcome.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Oncology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.en
dc.identifier.journalClinical Oncologyen

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