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Ann Oncol. 2009 Jun;20(6):1008-12. doi: 10.1093/annonc/mdn732. Epub 2009 Jan 15.

Unavoidable mastectomy for ipsilateral breast tumour recurrence after conservative surgery: patient outcome.

Author information

1
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy. edoardo.botteri@ieo.it

Abstract

BACKGROUND:

In the case of ipsilateral breast tumour recurrence (IBTR) after breast-conserving surgery (BCS), a second conservative surgical approach maybe considered in some motivated patients whereas in others mastectomy is unavoidable.

PATIENTS AND METHODS:

From 1997 to 2004, 282 patients presented at the European Institute of Oncology with an operable invasive IBTR after BCS. One hundred and sixty-one (57%) underwent a second conservative surgery, whereas 121 patients (43%) were given a mastectomy and represent the study population. We investigated the prognosis and determined predictive factors of outcome.

RESULTS:

Median time from primary breast cancer to IBTR was 41 months (range 5-213). Recurrences were T2-T4 and/or multifocal in 83 cases (68.6%). With a median follow-up of 5 years after mastectomy, 5-year overall survival (OS) and disease-free survival (DFS) were 73.3% [95% confidence interval (CI) 65.0% to 81.6%] and 50.4% (95% CI 40.9% to 59.8%), respectively. At the multivariate analysis, early onset of IBTR, presence of vascular invasion and Ki67 >or=20 of the recurrent tumour were found to significantly affect both DFS and OS.

CONCLUSIONS:

In women who need mastectomy for IBTR, early onset of the relapse, high proliferation index and presence of vascular invasion represent the worst prognostic factors.

PMID:
19150942
DOI:
10.1093/annonc/mdn732
[Indexed for MEDLINE]

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