Linnaus Maria E, Dueck Amylou C, Kosiorek Heidi E, Gray Richard J, Wasif Nabil, Northfelt Donald W, Anderson Karen S, McCullough Ann E, Wong William W, Halyard Michele Y, Patel Samir H, Pockaj Barbara A
Department of General Surgery, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
Department of Biostatistics, Mayo Clinic, Phoenix, AZ, USA.
Am J Surg. 2015 Dec;210(6):1155-60; discussion 1160-1. doi: 10.1016/j.amjsurg.2015.09.001. Epub 2015 Sep 28.
The incidence of all-location regional recurrence after sentinel lymph node biopsy is not well documented. This study attempts to identify risk factors.
A prospectively maintained database was queried to identify patients with a regional recurrence of breast cancer after a first operation for invasive unilateral breast cancer. Patients with regional recurrence were compared with those alive and disease free at 5 years.
Twenty-one of 1,060 patients (2%) experienced a regional recurrence. Most patients (95%) underwent sentinel lymph node biopsy as their axillary staging. Those with regional recurrences had larger tumors (P < .001), higher stage disease (P < .001), more estrogen receptor- and triple-negative breast cancers (P < .001), and more positive lymph nodes (P = .007). Mastectomy (P = .001) and receipt of neoadjuvant and/or chemotherapy (P < .001) were more common among those with regional recurrences.
Regional recurrence of breast cancer occurs infrequently. Risk factors include high-risk cancers, higher stage at presentation, nodal involvement, and need for therapies reflecting higher risk biology.
前哨淋巴结活检后全部位区域复发的发生率尚无充分记录。本研究旨在确定危险因素。
查询一个前瞻性维护的数据库，以识别单侧浸润性乳腺癌首次手术后出现区域复发的患者。将区域复发患者与5年时存活且无疾病的患者进行比较。
1060例患者中有21例（2%）出现区域复发。大多数患者（95%）接受了前哨淋巴结活检作为腋窝分期。区域复发患者的肿瘤更大（P <.001）、疾病分期更高（P <.001）、雌激素受体阳性和三阴性乳腺癌更多（P <.001）以及淋巴结阳性更多（P =.007）。乳房切除术（P =.001）以及接受新辅助和/或化疗（P <.001）在区域复发患者中更为常见。
乳腺癌区域复发很少见。危险因素包括高危癌症、就诊时分期较高、淋巴结受累以及需要反映高风险生物学特征的治疗。
