Long-term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer

Received 9 February 2005; received in revised form 6 April 2005; accepted 8 April 2005.

Abstract

We have studied the long-term prognosis of 266 patients considered to have isolated local recurrence in the breast following conservative surgery and radiotherapy for early breast cancer. The median follow-up of the patients still alive after diagnosis of local relapse was 11.2 years. At 10 years from the date of salvage treatment, the overall survival rate for the 226 patients with invasive local recurrence was 39% (95% CI, 32–46), the distant recurrence-free survival rate was 36% (95% CI, 29–42), and the local control rate (i.e., survival without subsequent local recurrence or local progression) was 68% (95% CI, 62–75). Among patients with a local recurrence at or near the original tumour site a better distant disease-free survival was observed for patients with recurrences measuring 1cm or less, compared to those with larger recurrences. This suggests, though does not prove, that early detection of local recurrence can improve the treatment outcome but might as well point towards a different biologic behaviour, facilitating early detection.

Keywords: Breast carcinoma, Breast conservation, Local recurrence, Detection, Survival, Long-term prognosis

a Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands

b Comprehensive Cancer Centre South, Eindhoven, The Netherlands

c Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands

d Department of Radiotherapy, Free University Medical Centre, Amsterdam, The Netherlands

e Department of Surgery, Erasmus Medical Centre/Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands

f Dr. Bernard Verbeeten Institute, Tilburg, The Netherlands

g Department of Radiotherapy, Catharina Hospital, Eindhoven, The Netherlands

h Radiotherapeutisch Instituut Friesland, Leeuwarden, The Netherlands

i Radiotherapeutisch Instituut Stedendriehoek, Deventer, The Netherlands

j Medisch Spectrum Twente, Enschede, The Netherlands

k Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

l Department of Surgery, Academic Hospital Maastricht, The Netherlands

m Zeeuws Radiotherapeutisch Instituut, Vlissingen, The Netherlands

n Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands

o Erasmus University Medical Centre, Department of Public Health, Rotterdam, The Netherlands

p Department of Radiotherapy, Academic Medical Centre, Amsterdam, The Netherlands

Corresponding author. Tel.: +31 43 3882387; fax: +31 433884128.

PII: S0959-8049(05)00548-4

doi:10.1016/j.ejca.2005.04.040

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