Prognosis of Surgical Treatment After Ipsilateral Breast Tumor Recurrence

Ipsilateral breast tumor recurrence (IBTR) was determined to be a powerful independent risk factor of distant disease and increased mortality. Although mastectomy is the standard salvage treatment for IBTR after breast conserving treatment, there is evidence that repeat breast conserving surgery (rBCS) might be a feasible alternative treatment.

The data of patients who were diagnosed with IBTR between 1998 and 2013 were obtained from the Surveillance, Epidemiology, and End Results database. Breast cancer-specific survival (BCSS) and overall survival (OS) were calculated using the Kaplan-Meier method. The Cox proportional hazards model was used for multivariate analysis, and propensity score matching analysis was applied to compensate for the differences in some baseline characteristics.

A total of 475 patients (22.9%) who underwent rBCS and 1600 (77.1%) who underwent mastectomy after IBTR were included in the study. During a median follow-up of 130 mo, no significant differences were observed in BCSS and OS between the rBCS and mastectomy groups of patients before and after propensity score matching. Multivariate analysis revealed that race, the American Joint Committee on Cancer stage of the recurrent tumor, and reirradiation were independent prognostic factors for both BCSS and OS.

The results of our study indicate that rBCS can be a feasible alternative treatment option for patients with IBTR. Nevertheless, further studies should be conducted to identify the prognosis of patients after rBCS as well as the best candidates for a second breast conserving surgery.