Related Experiment Video
Updated: Jul 18, 2026
13:35
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
When can a second conservative approach be considered for ipsilateral breast tumour recurrence?
O Gentilini1, E Botteri, N Rotmensz
1Division of Breast Surgery, European Institute of Oncology, Milan, Italy. oreste.gentilini@ieo.it
Summary
Mastectomy is often standard for breast cancer recurrence after breast-conserving surgery. However, a second conservative approach may be suitable for select patients with ipsilateral breast tumour recurrence, particularly those with smaller tumors and later relapses.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Mastectomy is the standard treatment for ipsilateral breast tumour recurrence (IBTR) post-breast-conserving surgery (BCS).
- Evaluating alternative approaches for IBTR is crucial for patient outcomes.
Purpose of the Study:
- To assess the prognosis of patients undergoing a second conservative approach for IBTR.
- To identify predictive factors for outcomes in IBTR patients.
- To determine patient subsets achieving optimal local control after repeat BCS.
Main Methods:
- Retrospective evaluation of 161 patients with invasive IBTR treated with a second conservative approach.
- Analysis of prognostic factors, including tumour size, Ki-67, time to relapse, and oestrogen receptor status.
- Assessment of local recurrence rates and overall survival.
Main Results:
- The 5-year cumulative incidence of local relapse was 31.4%, with 21.1% experiencing further in-breast recurrences.
- Recurrent tumour size >2 cm, Ki-67 >=20%, and time to relapse <=48 months were associated with poorer survival outcomes.
- Absence of oestrogen receptors negatively impacted overall survival.
- Patients with recurrent tumours <=2 cm and relapse >48 months had a 12.8% 5-year cumulative incidence of further local relapse.
Conclusions:
- A second breast-conserving surgery may be a viable option for selected IBTR patients.
- Factors such as small recurrent tumour size and late relapse are critical for achieving good local control.
- Patient preference should be considered alongside clinical factors when deciding on treatment for IBTR.
