Radiat Oncol J.
2013 Sep;31(3):138-146. 10.3857/roj.2013.31.3.138.
Treatment results of breast cancer patients with locoregional recurrence after mastectomy
- Affiliations
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- 1Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. watermountain@hanmail.net
- 2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 2051130
- DOI: http://doi.org/10.3857/roj.2013.31.3.138
Abstract
- PURPOSE
To analyze the results of locoregional and systemic therapy in the breast cancer patients with locoregional recurrence (LRR) after mastectomy.
MATERIALS AND METHODS
Seventy-one patients who received radiotherapy for isolated LRR after mastectomy between January 1999 and December 2009 were retrospectively reviewed. Among the 71 patients, 59 (83.1%) underwent wide excision and radiotherapy and 12 (16.9%) received radiotherapy alone. Adjuvant hormonal therapy was given to 45 patients (63.4%). Oncologic outcomes including locoregional recurrence-free survival, disease-free survival (DFS), and overall survival (OS) and prognostic factors were analyzed.
RESULTS
Median follow-up time was 49.2 months. Of the 71 patients, 5 (7%) experienced second isolated LRR, and 40 (56%) underwent distant metastasis (DM). The median DFS was 35.6 months, and the 3- and 5-year DFS were 49.1% and 28.6%, respectively. The median OS was 86.7 months, and the 5-year OS was 62.3%. Patients who received hormone therapy together showed better 5-year DFS and OS than the patients treated with locoregional therapy only (31.6% vs. 22.1%, p = 0.036; 66.5% vs. 55.2%, p = 0.022). In multivariate analysis, higher N stage at recurrence was a significant prognostic factor for DFS and OS. Disease free interval (< or =30 months vs. >30 months) from mastectomy to LRR was also significant for OS. The patients who received hormone therapy showed superior DFS and showed trend to better OS.
CONCLUSION
DM was a major pattern of failure after the treatment of LRR after mastectomy. The role of systemic treatment for LRR after mastectomy should be investigated at prospective trials.
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