Prognosis following local recurrence after breast conserving treatment in young women with early breast cancer

Sangen, M.J.C. van der; Poortmans, Philip; Scheepers, S.W.M.; Lemaire, Bea; Berlo, C.L.H. van; Tjan-Heijnen, Vcg; Voogd, Adri C.

doi:10.1016/j.ejso.2013.05.004

Cited by 20 publications

(10 citation statements)

References 32 publications

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“…Breast-conserving surgery (BCS) for early breast cancer patients has been well established for a number of years [ 1 2 3 4 ]. Although BCS is effective in prolonging survival compared with radical mastectomy, locoregional recurrence (LRR) rates are higher after BCS than following mastectomy [ 5 6 7 8 ]. Some studies have reported rates of LRR of 11% to 16% [ 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Lee

Park

et al. 2015

J Breast Cancer

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PurposeFew studies address independent prognostic factors after ipsilateral breast tumor recurrence (IBTR) following breast-conserving surgery (BCS). Locoregional recurrence is associated with distant metastases and increased mortality rates. Therefore anticipating prognoses after IBTR and evaluating risk factors for overall survival following a second salvage operation are important. We evaluated independent prognostic factors affecting overall survival after a second operation for IBTR.MethodsWe retrospectively identified 11,073 patients who underwent breast cancer surgery between November 1995 and December 2011. Locoregional recurrence occurred in 787 patients. Among them, IBTR developed in 165 patients selected for analysis. Excluding eight patients who refused further treatment, we analyzed 157 patients who underwent a second operation (partial mastectomy, 28 [17.8%]; total mastectomy, 129 [82.2%]) for IBTR. Excluding 26 patients with incomplete data, we evaluated the clinicopathol-ogical features influencing overall survival at the first and the second operation in the 131 patients who underwent a second operation.ResultsThe median age of patients at the first operation was 43.6 years (range, 27-69 years). The median duration from the first to the second operation was 45.0 months (range, 2.5-164.6 months). The 5-year overall survival rate after IBTR was 87.1%. In the multivariable analyses, duration from the first to the second operation, histopathology, lymph node status, and adjuvant chemotherapy, radiotherapy, and endocrine therapy at the first operation were independent prognostic factors for overall survival. Positive estrogen receptor status and endocrine therapy at the second operation were also associated with increased overall survival following salvage operations for IBTR.ConclusionThe time interval to IBTR following BCS is related to overall survival after salvage operation for IBTR and it is important to undergo optimal adjuvant treatments according to risk factors after the first operation because those risk factors affect overall survival for IBTR following BCS.

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Section: Introductionmentioning

confidence: 99%

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Lee

Park

et al. 2015

J Breast Cancer

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“…Young age is considered an independent negative prognostic factor for local recurrence [11][12][13] , contralateral BC 14,15 , and overall outcomes 16,17 . In addition, YWBC patients report a higher incidence of a family history of cancer, particularly BC 18,19 , suggesting a genetic component involved in the etiology of early-onset BC 19,20 .…”

Section: Histopathologic Features Of Tumors In Young Womenmentioning

confidence: 99%

Molecular Biology In Young Women With Breast Cancer: From Tumor Gene Expression To Dna Mutations

Gómez-Flores-Ramos¹,

Castro-Sánchez

Peña-Curiel

et al. 2017

RIC

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Young women with breast cancer (YWBC) represent roughly 15% of breast cancer (BC) cases in Latin America and other developing regions. Breast tumors occurring at an early age are more aggressive and have an overall worse prognosis compared to breast tumors in postmenopausal women. The expression of relevant proliferation biomarkers such as endocrine receptors and human epidermal growth factor receptor 2 appears to be unique in YWBC. Moreover, histopathological, molecular, genetic, and genomic studies have shown that YWBC exhibit a higher frequency of aggressive subtypes, differential tumor gene expression, increased genetic susceptibility, and specific genomic signatures, compared to older women with BC. This article reviews the current knowledge on tumor biology and genomic signatures in YWBC.

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“…Current evidence indicates worse outcomes following LR ( Halverson et al , 1992 ; Willner et al , 1997 ; Elkhuizen et al , 2001 ; van Duijnhoven et al , 2011 ) or a worse prognosis associated only with specific LR tumour subtypes ( Koscielny and Tubiana, 1999 ). It has been suggested that a shorter disease-free interval between the diagnosis of the primary tumour and a second lesion is a determinant of poor prognosis ( Vicini et al , 2003 ; Komoike et al , 2006 ; Anderson et al , 2009 ; Botteri et al , 2010 ; Vichapat et al , 2011 ; Tanis et al , 2012 ; van Laar et al , 2013 ), and a short interval usually signals that distant metastasis has already occurred ( van der Sangen et al , 2013 ). In one paper, the Early Breast Cancer Trialists Collaborative Group (EBCTCG) showed that in up to 25% of cases LR was likely associated with breast cancer death ( Early Breast Cancer Trialists' Collaborative G et al , 2011 ).…”

mentioning

confidence: 99%

Progression of breast cancer following locoregional ipsilateral recurrence: importance of interval time

Melvin¹,

Purushotham²,

Garmo³

et al. 2015

Br J Cancer

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Background:Studies comparing prognosis of breast cancer (BC) patients with and without locoregional recurrence (LR) present conflicting results. We aimed to improve our understanding of the impact of LR on prognosis by examining a large cohort of patients treated at Guy's and St Thomas' NHS Foundation Trust.Methods:Risk factors associated with BC-specific death were investigated using Cox proportional hazards regression in 5199 women diagnosed between 1975 and 2007. Breast cancer-specific death following LR was assessed with Poisson regression.Results:Overall, 552 women (11%) developed LR, with a median follow-up time of 4.28 years. Known factors associated with BC-specific death (tumour stage, grade, and nodal status) were of significance in our data. Women with a shorter disease-free interval had a worse prognosis. For instance, the HR for BC-specific death among women undergoing mastectomy with an LR 0.5–1 year after diagnosis of their primary tumour was 6.67 (95% CI: 3.71–11.99), when compared with women who did not experience LR.Conclusions:It often remains difficult to distinguish between a genuine LR and a new primary. The HRs for risk of BC-specific death following a second lesion suggest that they may act as a marker of systemic disease, large tumour burden, or depleted host defence. The clinically highly relevant impairment in prognosis calls for further research into the underlying mechanisms. We showed that for at least 15 years of follow-up, the prognosis in women following the occurrence of an LR may benefit from careful diagnostic and therapeutic management.

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Prognosis following local recurrence after breast conserving treatment in young women with early breast cancer

Cited by 20 publications

References 32 publications

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery

Molecular Biology In Young Women With Breast Cancer: From Tumor Gene Expression To Dna Mutations

Progression of breast cancer following locoregional ipsilateral recurrence: importance of interval time

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