Pattern of ipsilateral breast tumor recurrence after breast-conserving therapy.

Abstract

PURPOSE:

To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up.

METHODS AND MATERIALS:

We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event.

RESULTS:

The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors.

CONCLUSIONS:

We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.

• Authors: Jan Jobsen, Job van der Palen, Sietske Riemersma, Harald Heijmans, Francisca Ong, Henk Struikmans
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 89 Issue 5 Pg. 1006-1014 (Aug 01 2014) ISSN: 1879-355X [Electronic] United States
• PMID: 25035203 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Adult
• Age Factors
• Aged
• Axilla
• Breast Neoplasms (epidemiology, pathology, therapy)
• Carcinoma in Situ (epidemiology, pathology, therapy)
• Carcinoma, Lobular (epidemiology, pathology, therapy)
• Disease-Free Survival
• Female
• Humans
• Incidence
• Lymph Node Excision
• Lymph Nodes (pathology)
• Mastectomy, Segmental
• Middle Aged
• Neoplasm Grading
• Neoplasm Invasiveness (pathology)
• Neoplasm, Residual
• Neoplasms, Second Primary (epidemiology, pathology)
• Proportional Hazards Models
• Prospective Studies
• Time Factors