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Title: Pattern of Ipsilateral Breast Tumor Recurrence After Breast-Conserving Therapy

Purpose: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. Methods and Materials: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. Results: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. Conclusions: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, muchmore » higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.« less
Authors:
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [1] ;  [6] ;  [3]
  1. Department of Radiation Oncology, Medisch Spectrum Twente, Enschede (Netherlands)
  2. Department of Epidemiology, Medisch Spectrum Twente, Enschede (Netherlands)
  3. (Netherlands)
  4. Laboratory for Pathology Oost Nederland, Hengelo (Netherlands)
  5. Department of Surgery, Ziekenhuis Groep Twente, Hengelo (Netherlands)
  6. Department of Radiation Oncology, Leiden University Medical Centre, Leiden (Netherlands)
Publication Date:
OSTI Identifier:
22420387
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 89; Journal Issue: 5; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMPARATIVE EVALUATIONS; HAZARDS; LYMPH; MAMMARY GLANDS; THERAPY; WOMEN