title: Whose Disease Will Recur After Mastectomy for Early Stage, Node-Negative Breast Cancer? A Systematic Review.
abstract: Effective local control is associated with improved overall survival, particularly for women with early-stage cancers. No other local therapy is typically offered to women with T1-2 N0 breast cancer after mastectomy, although in select women the 5-year local recurrence rate can be as high as 20%. Therefore, accurately predicting the women who are at highest risk for recurrence after mastectomy will identify those who might benefit from more aggressive adjuvant treatment. A systematic search was conducted identifying risk factors associated with locoregional recurrence, including age, menopausal status, receptor status, lymphovascular invasion (LVI), margin status, use of systemic therapy, size, grade, and genomic classifer score. Although associations varied among studies, the risk factors most consistently identified were age ≤ 40 years, LVI, positive/close margin, and larger tumor size. In women with multiple high risk factors, risk of local recurrence was as high as 20% at 10 years. Additional multicenter studies are needed to investigate risk factors for locoregional recurrence after mastectomy without radiotherapy in T1-2N0 breast cancer. Consideration of additional adjuvant local therapy might be warranted in a subset of women at high risk of local recurrence.
authors.affiliation: Duke University School of Medicine, Durham, NC.
authors.forename: Collin
authors.initials: C
authors.lastname: Kent
authors.affiliation: Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC.
authors.forename: Janet
authors.initials: J
authors.lastname: Horton
authors.affiliation: Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC.
authors.forename: Rachel
authors.initials: R
authors.lastname: Blitzblau
authors.affiliation: Duke University School of Medicine, Durham, NC; Duke Cancer Institute, Durham, NC. Electronic address: bridget.koontz@duke.edu.
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Koontz
mesh_terms: D001943:Breast Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008408:Mastectomy; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D012307:Risk Factors
keywords: Chest wall; Local recurrence; Post-mastectomy radiation; Radiotherapy; Triple negative