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Multifocality in ipsilateral breast tumor recurrence - A study in ablative specimens.

Coco J E F Walstra1, Robert-Jan Schipper1, Ingrid G M Poodt1

  • 1Department of Surgery, Catharina Hospital Eindhoven, the Netherlands.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|May 14, 2020
PubMed
Summary

Multifocality in ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) occurs in 22.9% of cases. While not statistically significant, multifocal IBTR showed trends toward more chest wall re-recurrences and distant metastasis.

Keywords:
IBTRIpsilateral breast cancer recurrenceMultifocality

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Area of Science:

  • Oncology
  • Breast Cancer Research
  • Surgical Oncology

Background:

  • The incidence and clinical significance of multifocality in ipsilateral breast tumor recurrence (IBTR) following breast-conserving therapy (BCT) remain unclear.
  • Understanding multifocality in IBTR is crucial given the increasing interest in repeat BCT.
  • This study investigates the occurrence, predictive factors, and prognostic impact of multifocality in IBTR.

Purpose of the Study:

  • To determine the incidence of multifocality in ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT).
  • To identify patient- and tumor-related factors predicting multifocality in IBTR.
  • To assess the prognostic significance of multifocality in IBTR outcomes.

Main Methods:

  • Analysis of 215 patients with IBTR after BCT who underwent salvage mastectomy.
  • Utilized chi-squared tests and univariate logistic regression to identify predictive factors for multifocality.
  • Employed Kaplan-Meier analysis and log-rank tests to evaluate prognostic outcomes.

Main Results:

  • Multifocality was identified in 22.9% of IBTR mastectomy specimens.
  • Axillary positivity in IBTR was significantly associated with multifocal IBTR.
  • Trends indicated higher rates of chest wall re-recurrences (14% vs. 7%) and distant metastasis (24% vs. 15%) in multifocal IBTR, though not statistically significant.

Conclusions:

  • The prevalence of multifocality in IBTR is higher than in primary breast cancer.
  • Axillary positivity is a significant predictor of multifocal IBTR.
  • Multifocal IBTR may be associated with an increased risk of chest wall re-recurrences and distant metastasis.