title: Treatment results of breast cancer patients with locoregional recurrence after mastectomy.
abstract: OBJECTIVE
  To analyze the results of locoregional and systemic therapy in the breast cancer patients with locoregional recurrence (LRR) after mastectomy.
  
  
  METHODS
  Seventy-one patients who received radiotherapy for isolated LRR after mastectomy between January 1999 and December 2009 were retrospectively reviewed. Among the 71 patients, 59 (83.1%) underwent wide excision and radiotherapy and 12 (16.9%) received radiotherapy alone. Adjuvant hormonal therapy was given to 45 patients (63.4%). Oncologic outcomes including locoregional recurrence-free survival, disease-free survival (DFS), and overall survival (OS) and prognostic factors were analyzed.
  
  
  RESULTS
  Median follow-up time was 49.2 months. Of the 71 patients, 5 (7%) experienced second isolated LRR, and 40 (56%) underwent distant metastasis (DM). The median DFS was 35.6 months, and the 3- and 5-year DFS were 49.1% and 28.6%, respectively. The median OS was 86.7 months, and the 5-year OS was 62.3%. Patients who received hormone therapy together showed better 5-year DFS and OS than the patients treated with locoregional therapy only (31.6% vs. 22.1%, p = 0.036; 66.5% vs. 55.2%, p = 0.022). In multivariate analysis, higher N stage at recurrence was a significant prognostic factor for DFS and OS. Disease free interval (≤30 months vs. >30 months) from mastectomy to LRR was also significant for OS. The patients who received hormone therapy showed superior DFS and showed trend to better OS.
  
  
  CONCLUSIONS
  DM was a major pattern of failure after the treatment of LRR after mastectomy. The role of systemic treatment for LRR after mastectomy should be investigated at prospective trials.
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Jeong
authors.forename: Su Ssan
authors.initials: SS
authors.lastname: Kim
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Lee
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choi
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Joo
authors.forename: Seung Do
authors.initials: SD
authors.lastname: Ahn
keywords: Breast cancer; Locoregional recurrence; Mastectomy