title: Regional nodal recurrence after breast conservation treatment with radiotherapy for women with early-stage breast carcinoma.
abstract: OBJECTIVE
  To report the long-term outcomes for women presenting with regional lymph node recurrence after breast conservation treatment with radiotherapy for Stage I and II invasive breast carcinoma.
  
  
  METHODS
  Of the women with pathologic Stage I and II invasive breast carcinoma treated with breast conservation treatment at the University of Pennsylvania, 29 developed regional nodal recurrence as their first site of failure. An analysis of the patterns of regional nodal recurrence and their prognosis after recurrence was undertaken. The median follow-up from regional nodal recurrence was 5.4 years.
  
  
  RESULTS
  The pattern of regional nodal recurrence was as follows: 14 (48%) with simultaneous local and axillary recurrence, 7 (24%) with recurrence in the axilla only, 5 (17%) with recurrence in the supraclavicular region only, and 3 (10%) with multiple nodal sites of recurrence. For the entire study group, the 5-, 10-, and 15-year overall survival rate was 70%, 37%, and 28%, respectively. The 10-year overall survival rate for patients with locoregional recurrence was 32% compared with 45% for patients with regional-only recurrence (p = 0.50). The 10-year overall survival rate for patients with axillary recurrence discovered on pathologic examination of the mastectomy specimen was 31% compared with 42% for patients with palpable regional lymphadenopathy (p = 0.83).
  
  
  CONCLUSIONS
  Patients with regional nodal recurrence after breast conservation treatment with radiotherapy for early-stage breast carcinoma are potentially salvageable. The prognosis after regional nodal recurrence was not significantly different when stratified by the presence or absence of simultaneous in-breast recurrence or the method of detection.
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA 19104, USA. nick.lukens@uphs.upenn.edu
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Lukens
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hwang
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Solin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology* / Q000532:radiotherapy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult