[Local and regional recurrence of cancer of the breast]

The Authors, through the study of their patients, and comparing it to other reports, help to further define the meaning, prognosis and type of treatment of local recurrences (LR) in breast cancer. They study 25 cases of LR after 238 operations on which regular clinical follow-up was carried out. They consider the various prognostic indicators for LR, the types of treatment and the results which are reached. Median survival after LR treatment was significantly better in patients N- (49 months vs 7 months in N+: p = 0.004). LR was more frequent when primary tumor was situated in inner quadrants; only 36% of their cases depend on primaries of the upper outer quadrant. An aggressive treatment (surgery, radiotherapy, chemotherapy) insures a better survival even if primary cancer is N+ greater than 3. The importance for prognosis of lymphnodal status is confirmed. Possible explanations are presented regarding the relatively lower incidence in upper outer quadrant cancers. An aggressive treatment of LR is suggested, specially when prognostic indicators are unfavourable: LR is very often a sign of systemic relapse of illness, particularly when it occurs after a short disease-free interval.