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ABSTRACT: Repeat Lumpectomy for Patients with Ipsilateral Breast
Tumor Recurrence after Breast-Conserving Surgery: Preliminary
Results
In this study, we assessed the appropriateness of conducting repeat
lumpectomy for ipsilateral breast tumor recurrence (IBTR) based
on the characteristics of recurrence after primary breast conserving
surgery (BCS).
Of 41 patients who had developed IBTR from October
1986 to June 2000 at our institute, 11 underwent mastectomy of
the remaining breast and 30 underwent repeat lumpectomy.
The
5-year overall survival rate at a median follow-up of 43 months
after salvage surgery was 90.9% for the mastectomy group and
90.0% for the lumpectomy group. The 5-year distant disease-free
survival rate was 70.1% for the mastectomy group and 83.0% for
the lumpectomy group.
The survival rates were remarkably high
in both treatment groups, with no significant difference between
them. IBTRs in the majority of our patients were small lesions
less than 1 cm in diameter. They did not feature lymphatic invasion
and had low histological grade.
Compared with that of primary
lesions, the malignancy of recurrent tumors was not increased
in many patients. In contrast to these preferable features, 9
of 30 patients who underwent repeat lumpectomy developed second
local relapse within 3 years after salvage operation. Young age
(35 years), positive family history and omission of adjuvant
systemic therapy were found to exhibit trends as a discriminate
for further local recurrences.
In view of the relatively good
prognosis of IBTRs and excellent results of repeat lumpectomy,
we consider this method a treatment option that deserves serious
consideration if we can select the patients who will not likely
develop second local relapse.
[12/03/2002; Oncology]
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