Is breast conservation after local recurrence feasible?

Kurtz, John M.; Jacquemier, Jocelyne; Amalric, R; Brandone, H; Ayme, Y; Hans, Daniel; Bressac, C.; Spitalier, J. M.

doi:10.1016/0277-5379(91)90505-8

Cited by 108 publications

(52 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this important study, the authors demonstrated that 5-year local control rates were higher in patients who had negative margins of resection compared with patients with positive margins of resection (73% vs. 36%) and were higher in patients with a local recurrence occurring after 5 years compared with patients with shorter intervals to recurrence (92% vs. 49%%). 27 In a study from Sweden, Dalberg et al found that the local recurrence rate after local excision alone in 14 patients at a median follow-up of 13 years was an alarming 50%. 9 However, the authors did not explain why these patients were specifically chosen to undergo local excision alone, whether mammography or sonography was utilized to select appropriate patients, and whether negative margins of resection were obtained.…”

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 98%

“…6,8,9,17,27 The evaluation of these studies is difficult because of the lack of information regarding margin status and use of breast imaging at the time of in-breast local recurrence. Many of the series do not indicate whether clear surgical margins were obtained at the time of local excision of the recurrence, and numerous patients were treated before modern-day standard mammography and sonography were available to select appropriate patients for breast-conserving approaches (i.e., no evidence of multicentricity or diffuse suspicious microcalcifications).…”

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 99%

“…Kurtz et al 27 from Marseille reported on the feasibility and outcome of breast-conserving surgery after local recurrence in 50 patients. In this important study, the authors demonstrated that 5-year local control rates were higher in patients who had negative margins of resection compared with patients with positive margins of resection (73% vs. 36%) and were higher in patients with a local recurrence occurring after 5 years compared with patients with shorter intervals to recurrence (92% vs. 49%%).…”

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 99%

See 2 more Smart Citations

Repeat breast‐conserving surgery for in‐breast local breast carcinoma recurrence

Kuerer

Arthur

Haffty

2004

Cancer

View full text Add to dashboard Cite

Mastectomy is the current standard of care for in-breast local recurrence of breast carcinoma. The objective of the current study was to critically review the rationale for and the theoretic and actual risks and benefits of repeat breast-conserving surgery followed by partial breast irradiation (PBI) for in-breast local recurrence of breast carcinoma. The main outcomes of interest were local control and survival after in-breast local recurrence and side effects, complications, and cosmesis after reirradiation of the breast. The risk of local recurrence was not found to be eliminated with mastectomy; approximately 2-32% of patients treated with mastectomy develop a chest wall recurrence. The interpretation of local control rates in evaluating repeat breast-conserving surgery studies is difficult because of the lack of information regarding preoperative diagnostic mammography to rule out concurrent multicentric disease and microscopic margin status after surgery. Rates of subsequent local recurrence in these studies appeared to be between 19 -50%, similar to reported rates of in-breast local recurrence in patients with a first diagnosis of breast carcinoma who were treated with conservative surgery without irradiation. Early follow-up studies of breast reirradiation suggest that catheterbased interstitial brachytherapy and standard external beam radiation therapy can be delivered to the breast more than once without significant side effects in most patients and with acceptable cosmesis in some patients. Mastectomy may not be necessary in all patients with an in-breast local recurrence of breast carcinoma. KEYWORDS: recurrent breast carcinoma, breast surgery, radiation therapy, accelerated partial breast irradiation, three-dimensional conformal radiation therapy, brachytherapy.A t present, the standard surgical approach for the treatment of in-breast local recurrence of breast carcinoma is mastectomy. The rationale for the general consensus for this recommendation is threefold. First, a third local recurrence after repeat conservative surgery is reported in approximately 35% of patients. Second, a second lumpectomy would yield a cosmetically unacceptable outcome. Third, reirradiation of the whole breast after breast-conserving surgery is considered inappropriate because of the likelihood of serious tissue damage. Recently, novel brachytherapy devices and three-dimensional conformal radiation therapy techniques have brought accelerated partial breast irradiation (APBI) to the forefront as a potential treatment approach in women with in-breast local recurrence of 2269

show abstract

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 98%

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 99%

Section: Patient Outcomes After Conservative Surgery Alone For Inbreamentioning

confidence: 99%

See 1 more Smart Citation

Repeat breast‐conserving surgery for in‐breast local breast carcinoma recurrence

Kuerer

Arthur

Haffty

2004

Cancer

View full text Add to dashboard Cite

show abstract

“…Of note, IBTR was salvaged with partial mastectomy in 48.6%. Although data are sparse regarding the method of salvage surgery, partial mastectomy, which is equivalent to breast-conserving salvage surgery, seems higher than in existing studies (26)(27)(28)(29). This might be related to the fact that 29% (148/505) of patients had not received RT as initial treatment and RT can be administered safely after salvage surgery.…”

Section: ------------------------------------------------------------mentioning

confidence: 86%

Impact of radiation therapy on breast-conserving therapy for breast cancer in Japanese women: A retrospective analyses of multi-institutional experience. Kansai Breast Cancer Radiation Therapy Study Group

Mitsumori

Hiraoka²,

Inaji

et al. 2009

Oncol Rep

View full text Add to dashboard Cite

Abstract. Whole breast radiation therapy (RT) after breastconserving surgery is sometimes omitted in Japan; however, its impact on the outcome has not been properly evaluated. A multi-institutional retrospective study was conducted to clarify the impact of RT on local control after breast-conserving therapy (BCT). Data were collected from 3576 patients from 37 participating hospitals, of whom 1763 were eligible for analyses. Five hundred and five patients had ipsilateral breast tumor recurrence (IBTR) and 1258 patients did not. Details of IBTR were available for 245 of 505 patients who had IBTR, the location of IBTR was within or adjacent to the original tumor bed in 168 patients (68.6%). IBTR was salvaged with partial mastectomy in 119 patients (48.6%). Second recurrence in the ipsilateral breast was observed in 27 patients (11.0%). Univariate analyses demonstrated that administration of RT, the resection margin status, hormone responsiveness, T stage, N stage and stage were significantly related to IBTR. Multivariate analysis demonstrated that administration of RT, T stage and N stage were significantly correlated to IBTR. Among them, administration of RT had the largest impact on RT and it decreased the risk of IBTR by 77.3%. Omission of RT had the most significant impact on IBTR. RT should be given as a standard component of BCT.

show abstract

“…Reirradiation is generally not recommended. There is little published data on re-excision alone in this setting, but patients treated in this manner have a high risk of subsequent local relapse [60]. Therefore, re-excision should be reserved for patients who refuse mastectomy.…”

Section: Recurrence After Breast Conservation Therapy: Dr Dahlia Satmentioning

confidence: 99%

Breast Cancer in the Very Young Patient: A Multidisciplinary Case Presentation

et al. 2002

View full text Add to dashboard Cite

A case is presented that exemplifies many issues and controversies in the diagnosis and treatment of breast cancer in the very young. This woman was 22 years of age at diagnosis; she initially underwent breast-conservation therapy and adjuvant chemotherapy, retained fertility, had a subsequent uncomplicated pregnancy and delivery, and 7 years later developed a local recurrence in the breast. The discussion addresses risk factors, diagnosis, and treatment of breast cancer in the young; the impact of treatment on fertility; implications regarding pregnancy, and the management of local recurrence after breast conservation.

show abstract

Is breast conservation after local recurrence feasible?

Cited by 108 publications

References 15 publications

Repeat breast‐conserving surgery for in‐breast local breast carcinoma recurrence

Repeat breast‐conserving surgery for in‐breast local breast carcinoma recurrence

Impact of radiation therapy on breast-conserving therapy for breast cancer in Japanese women: A retrospective analyses of multi-institutional experience. Kansai Breast Cancer Radiation Therapy Study Group

Breast Cancer in the Very Young Patient: A Multidisciplinary Case Presentation

Contact Info

Product

Resources

About