The prognosis of patients with local recurrence more than five years after breast conservation therapy for invasive breast carcinoma.
OBJECTIVE
The increasing use of breast-conserving therapy (BCT) and the rising incidence and improved prognosis of early breast are causing a substantial increase in the absolute number of patients with a late local recurrence following BCT. This study examined the characteristics and the prognosis of patients with a local recurrence occurring more than 5 years after BCT.


METHODS
In the period 1982-1997, 3280 patients with invasive breast cancer underwent breast-conserving therapy in one of the eight community hospitals in the South-eastern part of The Netherlands. Of these patients, 98 developed a local recurrence in the breast more than 5 years after BCT.


RESULTS
Eighty-five of the 98 recurrences were invasive, 12 were purely in situ and for one patient this information was not available. The 5 years distant recurrence-free survival rate of 85 patients with a late invasive local recurrence was 68% (95% confidence interval [CI], 56-80) and significantly better than the rate of 41% (95% CI, 33-48) in an existing cohort of 173 patients with invasive recurrence within 5 years after BCT (p=0.007). Local excision of the recurrence was followed by a significantly lower local control rate than salvage mastectomy (50 vs 89%; p=0.004).


CONCLUSIONS
The prognosis of patients with a local recurrence more than 5 years after BCT is significantly better than of patients with local recurrence within 5 years after BCT.
van der Sangen
M J C
MJ
Department of Radiotherapy, Catharina Hospital, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands. maurice.vd.sangen@catharina-ziekenhuis.nl
van de Poll-Franse
L V
LV
Roumen
R M H
RM
Rutten
H J T
HJ
Coebergh
J W W
JW
Vreugdenhil
G
G
Voogd
A C
AC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
D000970:Antineoplastic Agents