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Updated: Jul 29, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Resultados de la segunda cirugía conservadora de mama sin reirradiación para la recurrencia del tumor mamario
Thomas Gaillard1,2, Arnaud Beddok3,4,5, Yousrah Baadj1,2
1Department Surgical Oncology, Institut Curie, Paris, France.
Background:
Breast-conserving therapy (BCT), combining breast-conserving surgery (BCS) and radiotherapy (RT), is a standard treatment for early stage breast cancer. Despite its effectiveness, patients remain at risk for ipsilateral breast tumor recurrence (IBTR). While mastectomy is traditionally recommended for IBTR, a second BCS with reirradiation (ReRT) has emerged as an alternative. However, there are limited data on outcomes for second BCS without ReRT in low-risk patients. This study aims to assess the outcomes of second BCS without ReRT in patients with low-risk IBTR.
Patients And Methods:
This retrospective cohort study included patients with low-risk IBTR who underwent second BCS without ReRT at the Curie Institute between 2001 and 2023. Eligible patients had hormone receptor-positive, HER2-negative tumors with low histological grade and a size ≤ 2 cm without evidence of lymph node involvement. Data were collected on local recurrence-free survival (LRFS), metastatic recurrence-free survival (MFS), and overall survival (OS).
Results:
Among 154 patients who underwent second BCS without ReRT, 119 had invasive carcinoma and 35 had ductal carcinoma in situ (DCIS). Over a median follow-up of 50 months, 11 patients (7.1%) experienced a second local recurrence, and 6 patients (3.8%) developed metastatic recurrence. Of these 6 metastatic cases, only 2 were associated with synchronous local recurrence. Importantly, no deaths were attributed to breast cancer in this cohort, highlighting the viability of this approach in low-risk patients. Overall survival at 36 months was 98% for invasive carcinoma and 100% for DCIS.
Conclusions:
Second BCS without ReRT offers favorable outcomes with low rates of recurrence and metastasis and no breast-cancer-specific mortality in selected low-risk IBTR patients, providing a viable alternative to mastectomy. Further studies with longer follow-up are necessary to confirm these findings and evaluate their applicability in higher-risk populations.
