title: Local recurrence risk after previous salvage mastectomy.
abstract: Breast-conserving surgery is a standard treatment for early breast cancer. For ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery, salvage mastectomy is the current standard surgical procedure. However, it is not rare for patients with IBTR who have received salvage mastectomy to develop local recurrence. In this study, we examined the risk factors of local recurrence after salvage mastectomy for IBTR.
  
  
  
  A total of 118 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent salvage mastectomy without irradiation for IBTR between 1989 and 2008 were included from eight institutions in Japan. The risk factors of local recurrence were assessed.
  
  
  
  The median follow-up period from salvage mastectomy for IBTR was 4.6 years. Patients with pN2 or higher on diagnosis of the primary tumor showed significantly poorer local recurrence-free survival than those with pN0 or pN1 at primary tumor (p < 0.001). Multivariate analysis showed that the lymph node status of the primary tumor was a significantly independent predictive factor of local recurrence-free survival (p = 0.02).
  
  
  
  The lymph node status of the primary tumor might be a predictive factor of local recurrence-free survival after salvage mastectomy for IBTR. Further research and validation studies are needed. (UMIN-CTR number UMIN000008136).
authors.affiliation: Dept. of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Tanabe
authors.affiliation: Dept. of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Okumura
authors.affiliation: Dept. of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Dept. of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Masuda
authors.affiliation: Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakatsukasa
authors.affiliation: Dept. of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shien
authors.affiliation: Section of Breast and Endocrine Surgery, Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Komoike
authors.affiliation: Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Taguchi
authors.affiliation: Dept. of Pathology, Kumamoto City Hospital, Kumamoto, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Arima
authors.affiliation: Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nishimura
authors.affiliation: Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Inaji
authors.affiliation: Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. Electronic address: isitobi-ma@mc.pref.osaka.jp.
authors.forename: M
authors.initials: M
authors.lastname: Ishitobi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000737:chemistry / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D016879:Salvage Therapy
keywords: Breast cancer; Breast-conserving surgery; Ipsilateral breast tumor recurrence; Local recurrence; Mastectomy