Management of Breast Cancer Locoregional Recurrence

Voinea, S.; Sandru, Angela; Blidaru, Alexandru

doi:10.21614/chirurgia.112.4.429

Cited by 12 publications

(12 citation statements)

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“…of older treatments and introduction of new therapies have resulted in improved outcomes (Clarke et al, 2005;The Early Breast Cancer Trialists' Collaborative Group, 2018;Weitz et al, 2005). Despite this, between 20% and 30% of patients will develop loco-regional recurrence or distant metastases in the years following primary treatment (Cardoso et al, 2018;Patrick & Khan, 2015;Voinea et al, 2017).…”

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confidence: 99%

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

et al. 2020

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Objective We aimed to determine the longitudinal prevalence and the predictors of sickness absence (SA) and disability pension (DP) in breast cancer (BC) women who eventually developed relapse. Methods A total of 1293 BC women, who were ages 20–63 years, diagnosed between 1996 and 2011 and by 2016 had all developed relapse, were identified in Swedish registers and were followed from two years before to five years after their primary diagnosis, while they were relapse‐free. Annual prevalence of SA and DP was calculated. Logistic regression was used to estimate adjusted odds ratios (AOR) for long‐term SA (>30 days) at one (y1) and three (y3) years post‐diagnosis. Results Prevalence of long‐term SA was 68.1% in y1 and 16.3% in y5. Prevalence of DP progressively increased from 16.3% in y1 to 29.0% in y5. Predictors of long‐term SA included age <50 years (y1:AOR = 1.79 [1.39–2.29]), TNM stage III (y1:AOR = 1.54 [1.03‐2.31]; y3:AOR = 2.21 [1.32–3.72]), metastasis (y1:AOR = 1.64 [1.26–2.12]; y3:AOR = 1.51 [1.05–2.18]), comorbidity (y1:AOR = 2.41 [1.55–3.76]; y3 AOR = 4.62 [2.49–8.57]) and any combination of radiotherapy, chemotherapy and hormonal therapy (y1:AOR = 2.05–5.71). Conclusion Among BC women who later developed relapse, those who had higher stages of BC, had comorbidity and received neoadjuvant and/or adjuvant therapy were at significantly higher risk of needing long‐term SA after their diagnosis.

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confidence: 99%

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

et al. 2020

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“…12 In other reports, the incidence of local recurrence following breast-conserving therapy ranges from 10 to 22 percent at 10 years, and the median time from tumor resection to recurrence is 3 to 4 years. 1,13 The literature for long-term recurrence following oncoplastic reduction is limited, as is evidence supporting the long-term oncologic safety of this technique.…”

Section: Discussionmentioning

confidence: 99%

The Impact Oncoplastic Reduction Has on Long-Term Recurrence in Breast Conservation Therapy

Losken

Smearman

Hart

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: The use of oncoplastic reduction techniques have many proven benefits over lumpectomy alone in the management of women with breast cancer. The impact it has on tumor recurrence is unclear. The purpose of this review was to evaluate the incidence of recurrence in patients who underwent oncoplastic reduction techniques compared to lumpectomy alone. Methods: A prospectively maintained database of patients at Emory Hospital who underwent oncoplastic reduction techniques at the time of tumor resection was queried. These patients were compared to a series of patients who had lumpectomy alone over a similar period. For inclusion in the study, patients were at least 10 years since the time of the tumor resection. The main outcome of interest was tumor recurrence. Results: There were 97 patients in the lumpectomy-only group and 95 patients in the oncoplastic reduction group, with an average follow-up of 7.8 years and 8.5 years, respectively. Patients in the oncoplastic group were younger (lumpectomy only, 61.4 years; oncoplastic reduction, 51.6 years; p < 0.001) and had larger tumors (lumpectomy only, 1.1 cm; oncoplastic reduction, 1.6 cm; p < 0.001). Local recurrence was 13 percent in the lumpectomy-only group and 9 percent in the oncoplastic reduction group (p = 0.34), and overall recurrence rates were similar (lumpectomy only, 15 percent; oncoplastic reduction, 24 percent; p = 0.13). Overall, surgical intervention (lumpectomy alone versus oncoplastic reduction) was not associated with local recurrence or any recurrence on univariate and multivariate analyses. Conclusion: Despite the oncoplastic reduction patients having a higher risk of recurrence and a more generous tumor resection, the long-term recurrence rates were equivalent when compared to breast-conserving therapy alone. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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“…The selection of these women were decided on a case-by-case basis by PCR. There are no standards; anatomopathology, hormone receptor positivity or not, age, and previous medical treatments are taken into account [22]. Locoregional recurrence as the first event after conservative treatment of breast cancer is an independent risk factor for poor long-term prognosis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Breast Cancer Recurrence after Conservative Treatment

BENJELLOUN¹,

OMRAN²,

BOUAB³

et al. 2022

Int J Res Oncol

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Breast cancer is nowadays a real public health problem all over the world. Conservative therapy has been one of the approved treatment options for several years. The objective of this work was to describe the prognostic factors of breast cancer recurrence in our context after conservative treatment. We performed a retrospective study with analysis of clinical, pathological, and therapeutic parameters in patients with breast cancer recurrence after conservative treatment over a period of 2 years. During the study period, a total of 17 patients were selected. The mean age at diagnosis of the primary tumor was 54.56 years. The occurrence of recurrence was correlated with advanced tumor size with a rate of 64.7% for stage 2, lymph node invasion in 11 patients or 41.18%, and the presence of metastasis which was present in 2 patients. On the other hand, invasive ductal carcinoma was the most frequent histological type with 13 cases (76.47%) with predominantly intermediate or high SBR histopronostic grades (II and III: 47.05% each), vascular emboli and Comedonecrosis was present in 3 patients (17.64%), and the resection margins were healthy in all patients. As for estrogen receptors, they were positive in 9 patients, i.e., 52.94% of cases and those of a progesterone type were present in 8 patients (47.05%), HER-2 receptors were overexpressed in 3 patients (17.64%) and Ag Ki67 was greater than 20 in 76.47% of cases. Thus, 8.33% of the tumors were classified Luminal A, 47.06% were Luminal B, 11.76% were of the HER-2 type, and 35.29% were triple negative. All our patients had benefited from conservative treatment of the primary tumor made by conservative surgery followed by radiotherapy, with a delay between surgery and radiotherapy ranging from 8 to 23 months in patients who received chemotherapy and an average of 11 months, and from 4 to 8 months in patients who received radiotherapy directly after surgery, for an average of 5.25 months, on the other hand, adjuvant chemotherapy was administered in 11 patients (64.70%), hormone therapy was prescribed for 9 patients (52.94%) and only one patient had benefited from targeted therapy such as HERCEPTIN. In conclusion, conservative treatment is currently indicated in most T1 and T2 mammary carcinomas given that it constitutes a therapeutic alternative combining carcinological and aesthetic benefits, however much remains to be done to be able to optimize its results and thus minimize the risk of recurrence.

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Management of Breast Cancer Locoregional Recurrence

Cited by 12 publications

References 30 publications

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

Sickness absence and disability pension among swedish women prior to breast cancer relapse with a special focus on the roles of treatment and comorbidity

The Impact Oncoplastic Reduction Has on Long-Term Recurrence in Breast Conservation Therapy

Prognostic Factors for Breast Cancer Recurrence after Conservative Treatment

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