title: Repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery: the impact of radiotherapy on second IBTR.
abstract: OBJECTIVE
  There are limited data on the outcomes of patients treated with repeat lumpectomy at the time of ipsilateral breast tumor recurrence (IBTR). Especially, the impact of radiotherapy (RT) on a second IBTR is unknown.
  
  
  METHODS
  We retrospectively analyzed 143 patients from 8 institutions in Japan who underwent repeat lumpectomy after IBTR. The risk factors of a second IBTR were assessed.
  
  
  RESULTS
  The median follow-up period was 4.8 years. The 5-year second IBTR-free survival rate was 80.7 %. There was a significant difference in the second IBTR-free survival rate according to RT (p = 0.0003, log-rank test). The 5-year second IBTR-free survival rates for patients who received RT after initial surgery, RT after salvage surgery, and no RT were 78.0, 93.5, and 52.7 %, respectively. Multivariate analysis revealed that RT was a significantly independent predictive factor of second IBTR-free survival.
  
  
  CONCLUSIONS
  Repeat lumpectomy plus RT is a reasonable option in patients who did not undergo RT at the initial surgery. In contrast, caution is needed when RT is omitted in patients who have undergone repeat lumpectomy.
authors.affiliation: Departments of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan, isitobi-ma@mc.pref.osaka.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishitobi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okumura
authors.forename: Reiki
authors.initials: R
authors.lastname: Nishimura
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakatsukasa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tanabe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshida
authors.forename: Norikazu
authors.initials: N
authors.lastname: Masuda
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shien
authors.forename: Satoru
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Komoike
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Arima
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Inaji
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human