title: Local recurrence of breast cancer after mastectomy and modern multidisciplinary treatment.
abstract: BACKGROUND
  To study the incidence of local recurrence (LR) of early breast cancer in the ipsilateral thoracic wall after mastectomy and outcome of patients with LR.
  
  
  METHODS
  A retrospective cohort study based on 2220 consecutive breast cancer patients treated at the Helsinki University Central Hospital, Finland, in 2000 to 2003. A subset of 755 (34.0%) patients had mastectomy which was usually followed by postoperative radiotherapy (51.2%) and/or systemic adjuvant therapy (79.2%).
  
  
  RESULTS
  During a median follow-up of 89 months, 22 (2.9%) patients treated with mastectomy had LR. The median time to LR was 27 months. None of the 12 patient- or tumour-related standard risk factors studied were independently associated with LR-free survival in a multivariate model. Six (27.3%) of the 22 patients with LR had distant metastases diagnosed either prior to or simultaneously with LR. The subset of 16 patients who were diagnosed with LR without concomitant distant recurrence had five-year breast cancer-specific survival of 77.5% as calculated from the date of LR detection, and overall survival of 59.2%.
  
  
  CONCLUSIONS
  LR after mastectomy has become a rare event. Most women with isolated LR survive for five years after LR.
authors.affiliation: Breast Surgery Unit, Helsinki University Central Hospital, Helsinki, Finland. elina.siponen@hus.fi
authors.forename: Elina T
authors.initials: ET
authors.lastname: Siponen
authors.forename: Heikki
authors.initials: H
authors.lastname: Joensuu
authors.forename: Marjut H K
authors.initials: MH
authors.lastname: Leidenius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal; D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy; D055815:Young Adult
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; C508053:ERBB2 protein, human