title: Salvage treatment for loco-regional recurrence following breast conservation therapy for early breast cancer.
abstract: We reviewed the management of 55 cases of loco-regional recurrence after limited surgery and irradiation for breast cancer. Forty-three patients had disease localized to the breast, with axillary involvement in seven. Four had axillary relapse without tumor recurrence in the breast. Eight had breast recurrence extending to involve the chest wall. Mastectomy was used successfully for 41 first recurrences, and seven were controlled by wide excision; 21 of 48 patients also received chemotherapy and/or hormonal manipulation. Diffuse soft-tissue tumor required systemic therapy first, followed by wide excision when possible. Eighty-nine percent of first recurrences were controlled but disease recurred again in eight patients. Overall, 80% of cases were free of loco-regional disease at a median follow-up of 27 months. Reconstructive surgery was valuable for wound closure after wide resections, and for cosmetic procedures. Despite the previous irradiation, surgery complications were acceptable.
authors.affiliation: Department of Surgery, University of Texas, MD Anderson Cancer Center, Houston 77030.
authors.forename: A
authors.initials: A
authors.lastname: Stotter
authors.forename: S
authors.initials: S
authors.lastname: Kroll
authors.forename: M
authors.initials: M
authors.lastname: McNeese
authors.forename: F
authors.initials: F
authors.lastname: Holmes
authors.forename: M J
authors.initials: MJ
authors.lastname: Oswald
authors.forename: M
authors.initials: M
authors.lastname: Romsdahl
mesh_terms: D000206:Actuarial Analysis; D001365:Axilla; D001943:Breast Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D013524:Surgical Flaps; D013514:Surgical Procedures, Operative / Q000379:methods; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000556:secondary; D014481:United States