[The long-term prognosis of locally recurrent breast cancer after breast conserving treatment].
OBJECTIVE
To study the long-term prognosis of patients with locally recurrent breast cancer following breast-conserving treatment.


METHODS
Descriptive.


METHODS
Data were collected on 266 patients in 11 Dutch centres; in these patients, an isolated local recurrence of an infiltrating mammary carcinoma for which they had received breast-conserving treatment was diagnosed before January 1st, 1994. The median age was 45 years (range 16-81) at the time of treatment of the primary tumour and 49 years (range 17-82) at the time of diagnosis of the local recurrence. The patients were followed through December 2002. The median follow-up after local recurrence of those patients who were still alive was 11.2 years.


RESULTS
Of the 226 patients with an infiltrating local recurrence, 148 (65%) had died and 145 (64%) had developed distant metastases. Of the metastases, 61% appeared within 2.5 years and 87% within 5 years after treatment of the local recurrence. 10 years after treatment of the local recurrence, the overall survival rate was 39% (95% CI: 32-46) and the distant metastasis-free survival rate was 36% (95% CI: 29-42). The prognosis of patients with a local recurrence occurring at a different site in the breast was the same as that of patients with a local recurrence < or = 1 cm in diameter occurring at or near the original tumour site. Both of these groups had a better prognosis than patients with a recurrence larger than 1 cm at the site of the original tumour or patients with a diffuse recurrence.


CONCLUSIONS
Almost two-thirds of the patients with an invasive local recurrence following breast-conserving surgery for invasive breast cancer developed distant metastases. Both the exact location in the breast and the size of the local recurrence appeared to be predictors of the risk of subsequent metastatic disease.
Voogd
A C
AC
Universiteit Maastricht, capaciteitsgroep Epidemiologie, Postbus 616, 6200 MD Maastricht. adri.voogd@epid.unimaas.nl
Rutgers
E J T
EJ
van Tienhoven
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors