Prognosis after breast recurrence following conservative surgery and radiotherapy in patients with node-negative breast cancer

Authors

  • M. Francis,

    1. Division of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia
    2. New South Wales Breast Cancer Institute, University of Sydney, Westmead, New South Wales, Australia
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  • B. Cakir,

    1. New South Wales Breast Cancer Institute, University of Sydney, Westmead, New South Wales, Australia
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  • O. Ung,

    1. New South Wales Breast Cancer Institute, University of Sydney, Westmead, New South Wales, Australia
    2. Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia
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  • V. Gebski,

    1. Division of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia
    2. National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
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  • Associate Professor J. Boyages

    Corresponding author
    1. Division of Radiation Oncology, Westmead Hospital, Westmead, New South Wales, Australia
    2. New South Wales Breast Cancer Institute, University of Sydney, Westmead, New South Wales, Australia
    • New South Wales Breast Cancer Institute, PO Box 143, Westmead, New South Wales 2145, Australia
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Abstract

Background:

Breast conservation surgery with radiotherapy is a safe and effective alternative to mastectomy for early-stage breast cancer. This retrospective study examined the outcome of patients with isolated local recurrence following conservative surgery and radiotherapy in node-negative breast cancer.

Methods:

Between November 1979 and December 1994, 503 women with node-negative breast cancer were treated by conservation surgery and radiotherapy without adjuvant systemic therapy.

Results:

After a median follow-up of 73 months the 5-year rate of freedom from local recurrence was 94 per cent. Thirty-five patients developed an isolated local recurrence within the breast as a first event. Thirty-three patients were treated with salvage mastectomy and two patients were treated with systemic therapy alone. The 5-year rate of freedom from second relapse was 46 per cent and the overall 5-year survival rate was 59 per cent for patients who had salvage mastectomy. Patients who developed breast recurrence as a first event had a 3·25 greater risk of developing distant metastasis (P < 0·001) than those who did not have breast recurrence as a first event.

Conclusion:

Salvage mastectomy after local recurrence was an appropriate treatment if there was no evidence of distant metastasis. Breast recurrence after conservative surgery and radiotherapy in node-negative breast cancer predicted an increased risk of distant relapse. © 1999 British Journal of Surgery Society Ltd

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