Identification of patients who are at high risk for locoregional breast cancer recurrence after conservative surgery and radiotherapy: a review article for surgeons, pathologists, and radiation and medical oncologists.
OBJECTIVE
Many retrospective reports have been published identifying risk factors for locoregional (LR) recurrence after breast conservation therapy (BCT). We review these reports, with the purpose of better enabling surgeons, pathologists, radiation oncologists, and medical oncologists to develop strategies for an individualized treatment approach.


RESULTS
English-language retrospective and prospective randomized studies published in the 1980s were reviewed. Histopathologic predictors, young age, extent of conservative surgery (CS), lobular carcinoma, and the impact of adjuvant chemotherapy are all examined as reported risk factors for LR.


CONCLUSIONS
Recognition of these factors provides rationale for individualizing the extent of CS based on histopathologic features. In addition, the aggressiveness of radiotherapy (RT) should be dictated by the extent of CS and by identifiable prognostic factors. Strategies are presented for an individualized treatment approach based on a clear understanding of the prognostic factors for LR.
Clarke
D H
DH
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI.
Martinez
A A
AA
D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000473:pathology* / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D012307:Risk Factors