title: Four types of ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery: classification of IBTR based on precise pathological examination.
abstract: We classified ipsilateral breast tumor recurrences (IBTRs) based on strict pathological rules. Ninety-six women who were surgically treated for IBTR were included. IBTRs were classified according to their origins and were distinguished based on strict pathological rules: relationship between the IBTR and the primary lumpectomy scar, surgical margin status of the primary cancer, and the presence of in situ lesions of IBTR. The prognosis of these subgroups were compared to that of new primary tumors (NP) in the narrow sense (NPn) that occurred far from the scar. Distant-disease free survival of IBTR that occurred close to the scar with in situ lesions and a negative surgical margin of the primary cancer (NP occurred close to the scar, NPcs) was similar to that of NPn. In contrast, IBTR that occurred close to the scar without in situ lesions (true recurrence (TR) that arose from residual invasive carcinoma foci, TRinv) had significantly poorer prognosis than NPn. IBTR that occurred close to the scar with in situ lesions and a positive surgical margin of the primary cancer (TR arising from a residual in situ lesion, TRis) had more late recurrences than NPcs. Precise pathological examinations indicated four distinct IBTR subtypes with different characteristics.
authors.affiliation: Department of Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Sakai
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Nishimura
authors.forename: Akiko
authors.initials: A
authors.lastname: Ogiya
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tanabe
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Kimura
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Morizono
authors.forename: Kotaro
authors.initials: K
authors.lastname: Iijima
authors.forename: Yumi
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Masujiro
authors.initials: M
authors.lastname: Makita
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oguchi
authors.forename: Rie
authors.initials: R
authors.lastname: Horii
authors.forename: Futoshi
authors.initials: F
authors.lastname: Akiyama
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwase
mesh_terms: D001943:Breast Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000145:classification* / Q000401:mortality / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology
keywords: breast cancer; breast-conserving surgery; ipsilateral breast tumor recurrence; new primary tumor; true recurrence