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Is breast conservation after local recurrence feasible?
J M Kurtz1, J Jacquemier, R Amalric
1Radiation Oncology Division, University Hospital, Geneva, Switzerland.
European Journal of Cancer (Oxford, England : 1990)
|January 1, 1991
Summary
Wide excision for recurrent breast cancer offers good local control, especially for late recurrences. Achieving negative resection margins is crucial for successful conservative salvage surgery.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Breast conserving treatment (BCT) is standard for early breast cancer.
- Intramammary recurrences after BCT require effective salvage strategies.
- Conservative approaches aim to preserve breast tissue while achieving local control.
Purpose of the Study:
- To evaluate the feasibility and outcomes of wide excision for intramammary recurrences after BCT.
- To identify factors influencing local control after salvage surgery.
- To assess wide excision as an alternative to mastectomy for recurrent breast cancer.
Main Methods:
- Clinicopathologic study of 50 patients undergoing wide excision for intramammary recurrence.
- Median follow-up of 51 months.
- Cox multivariate analysis of 18 parameters to determine predictors of local control.
Main Results:
- 16 (32%) patients experienced second local failures, with a 5-year local control rate of 62%.
- Disease-free interval (DFI) and resection margins were significant predictors of local control.
- 5-year local control was 92% for recurrences >5 years DFI vs. 49% for shorter intervals; 73% for negative margins vs. 36% for positive/indeterminate margins.
- Local control was independent of tumor features and patient demographics.
Conclusions:
- Wide excision is a satisfactory salvage option for intramammary recurrences, particularly for late recurrences.
- Negative resection margins are essential for successful local control.
- Further research is needed to refine patient selection for this conservative approach.