Local-Regional Breast Cancer Recurrence Following Mastectomy

Crowe, Joseph P.; Gordon, N. H.; Antunez, Antonio R.; Shenk, Robert; Hubay, Charles A.; Shuck, Jerry M.

doi:10.1001/archsurg.1991.01410280027002

Cited by 77 publications

(34 citation statements)

References 23 publications

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“…The mean and median follow-ups were not given. Both Donegan et al 9 and Crowe et al 10 have analyzed the time course for LR in a large Factors associated with local recurrence after SSM have not been previously analyzed in detail. In the study by Kroll et al, 6 the incidence of LR was lower (6.2%) in patients with T1 tumors than with T2 tumors (9.3%).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Local Recurrence After Skin-Sparing Mastectomy and Immediate Breast Reconstruction for Invasive Breast Cancer

Medina‐Franco¹,

Vásconez²,

Fix³

et al. 2002

Annals of Surgery

262

123

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ObjectiveTo examine the incidence of local recurrence (LR) and factors associated with it in a population of patients who underwent skin-sparing mastectomy (SSM) and immediate reconstruction for invasive carcinoma. Summary Background DataThe efficacy of SSM has been challenged by concerns about increased risks of LR. MethodsA consecutive series of 173 patients (176 cancers) with invasive carcinoma underwent SSM and immediate breast reconstruction (June 1986 to December 1997). Data were analyzed by the Kaplan-Meier method, the log-rank statistic test, and the Cox proportional hazards model. ResultsMean patient age was 47 Ϯ 9 years (27% were 40 or younger). The AJCC stages were 1 ϭ 43%, 2 ϭ 52%, and 3 ϭ 5%.Thirty percent of tumors were poorly differentiated. With a median follow-up of 73 months, the LR rate was 4.5%. The mean local relapse-free interval was 26 months. Seventy-five percent of patients who presented with LR developed distant metastases and died of disease within a mean of 21 months. On univariate analysis, factors associated with higher LR rate were tumor stage 2 or 3, tumor size larger than 2 cm, nodepositive disease, and poor tumor differentiation. Actuarial 1-, 3-, and 5-year overall survival rates were 98%, 94%, and 88%, respectively. On multivariate analysis, factors associated with decreased survival were advanced stage, presence of LR, and absence of hormone therapy. LR was a highly significant predictor of tumor-related death. ConclusionsThere is a low incidence of LR after SSM, and it is associated with advanced disease at presentation. LR is an independent risk factor for tumor-related death.Skin-sparing mastectomy (SSM) has been advocated as an oncologically safe approach for the management of patients with early-stage breast cancer. This operation also minimizes deformity and improves cosmesis through preservation of the skin envelope of the breast.1-5 Chest wall skin is a common site of local failure after mastectomy, and the incidence of this event after SSM has been reported to be 0% 5 to 7%. 6 Although the results of SSM have been analyzed in previous reports, many of these series included patients with invasive and noninvasive breast cancer with variable lengths of follow-up. The objective of this study was to examine survival rates, incidence of local recurrence (LR), and factors associated with it in a population of patients who underwent SSM and immediate breast reconstruction for invasive breast cancer at a single institution. METHODSA retrospective review was performed of patients who underwent SSM and immediate breast reconstruction from Correspondence: Marshall M.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Local Recurrence After Skin-Sparing Mastectomy and Immediate Breast Reconstruction for Invasive Breast Cancer

Medina‐Franco¹,

Vásconez²,

Fix³

et al. 2002

Annals of Surgery

262

123

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“…In this study, 75% of patients who developed LR within a median follow-up of 73 months developed distant metastases and died of disease within a mean of 21 months. Other reports of patients with recurrent breast cancer after mastectomy have shown that approximately 70% of LRs occur in the first 36 months [12,13], while 90% are detected within five years of initial diagnosis [14]. Although several studies have reported worse prognosis with LR after mastectomy than after breast conservation therapy [8,[14][15][16], this more adverse impact of LR on survival after mastectomy has not been supported by others [3].…”

Section: Discussionmentioning

confidence: 98%

Invasive Breast Cancer after Mastectomy and Autologous Breast Reconstruction

Zakaria

Herrick

Reynolds

et al. 2009

Scholarly Research Exchange

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Recurrence or new breast cancer after mastectomy and autologous breast reconstruction is a rare occurrence. We present a case series of four patients with this rare phenomenon and describe their presentation, workup, and surgical and adjuvant therapy. We discuss the possible physiologic mechanisms leading to tumor recurrence in a reconstructed breast along with literature review. A new palpable mass in a reconstructed breast mound warrants tissue diagnosis to avoid delay in treatment. The surgical options for breast cancer in tissue reconstructions depend on the location and extent of the tumor, involvement of the vascular pedicle, stage of disease, and adjuvant therapy options.

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“…Locoregional recurrence occurs in up to 35% of patients by 10 years after mastectomy or breast-conserving therapy (1). Mammography is less sensitive in the treated breast than in the untreated breast due to surgery and radiation-induced changes in the parenchymal pattern (2).…”

Section: Introductionmentioning

confidence: 99%

“…In this case report we aimed to determine the contribution of MRI and advanced MRI techniques (DWI and single voxel 1 H MR spectroscopy) to a lesion which was detected by conventional methods in an operated breast carcinoma patient.…”

Section: Introductionmentioning

confidence: 99%

Chronic Hematoma Mimicing Recurrent Breast Carcinoma and Contribution of Magnetic Resonance Imaging to the Diagnosis

Başara¹,

Örgüç²,

Tireli³

2013

J Breasth Health

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Local recurrence of breast carcinoma after breast conservative therapy is an unwanted situation with a high possibility. Paranchymal distortion and edema secondary to surgery and radiotheraphy results in difficulties in the mammographic and ultrasonographic evaluation of the breast. After treatment of breast carcinoma, sensitivity of mammography decreases below the normal population. Breast magnetic resonance imaging (MRI) can be helpful in the discrimination of scar tissue in the region of operation from local recurrence. Advanced MRI applications such as diffusion weighted imaging (DWI) and proton ( 1 H) MR spectroscopy also have contribution in diagnosis. In this case report we aimed to determine the contribution of MRI and advanced MRI techniques to a lesion which was detected by conventional methods in an operated breast carcinoma patient.Key words: Breast cancer, diffusion weighted imaging, hematoma, magnetic resonance imaging, proton magnetic resonance spectroscopy ÖZETMeme kanserinin lokal rekürrensi meme koruyucu tedavi sonrası istenmeyen ve büyük olasılığı olan bir durumdur. Parankimal distorsiyon, cerrahiye sekonder ödem ve radyoterapi mammografik ve ultrasonografik değerlen-dirimi zorlaştırır. Meme karsinomunun tedavisi sonrası, mammografinin sensitivitesi normal popülasyonun altındadır. Meme manyetik rezonans görüntüleme (MRG), operasyon alanında skar dokusunun ayrımında yardımcı olabilir. Difüzyon ağırlıklı görüntüleme (DAG) ve proton ( 1 H) manyetik rezonans (MR) spektroskopi gibi ileri MRG uygulamalarının da tanıya katkısı vardır. Bu olgu sunumunda, MRG ve ileri MRG tekniklerinin konvansiyonel yöntemlerle opere meme karsinomlu bir hastada saptanan bir lezyonun tanıya katkısının değerlendirmeyi amaçladık.Anahtar sözcükler: Meme kanseri, difüzyon manyetik rezonans, hematom, manyetik rezonans görüntüleme, proton manyetik rezonans görüntüleme IntroductionRecurrence of disease at locoregional and distant sites occurs frequently in women who have undergone primary treatment for breast cancer. Locoregional recurrence occurs in up to 35% of patients by 10 years after mastectomy or breast-conserving therapy (1). Mammography is less sensitive in the treated breast than in the untreated breast due to surgery and radiation-induced changes in the parenchymal pattern (2). Magnetic resonance imaging (MRI) is a very useful method in diagnosis of breast lesions which cannot be characterized by mammography, ultrasonography (US) and physical examination (3). Advanced MRI applications such as diffusion weighted imaging (DWI) and proton ( 1 H) magnetic resonance (MR) spectroscopy also have contribution in diagnosis (4, 5).In this case report we aimed to determine the contribution of MRI and advanced MRI techniques (DWI and single voxel 1 H MR spectroscopy) to a lesion which was detected by conventional methods in an operated breast carcinoma patient. Case ReportA 67-year-old patient with the diagnosis of invasive ductal carcinoma was evaluated in her third post-operative year, after breast conservation therap...

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Local-Regional Breast Cancer Recurrence Following Mastectomy

Cited by 77 publications

References 23 publications

Factors Associated With Local Recurrence After Skin-Sparing Mastectomy and Immediate Breast Reconstruction for Invasive Breast Cancer

Factors Associated With Local Recurrence After Skin-Sparing Mastectomy and Immediate Breast Reconstruction for Invasive Breast Cancer

Invasive Breast Cancer after Mastectomy and Autologous Breast Reconstruction

Chronic Hematoma Mimicing Recurrent Breast Carcinoma and Contribution of Magnetic Resonance Imaging to the Diagnosis

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