Ishitobi Makoto, Fukui Reiko, Hashimoto Yoko, Kittaka Nobuyoshi, Nakayama Takahiro, Tamaki Yasuhiro
Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan.
Anticancer Res. 2017 Sep;37(9):5293-5299. doi: 10.21873/anticanres.11955.
There is little information on the local recurrence risk of patients who undergo repeat lumpectomy without radiotherapy after salvage surgery for ipsilateral breast tumor recurrence (IBTR).
Sixty-five patients who underwent repeat lumpectomy without radiotherapy after IBTR were retrospectively analyzed. The risk factors of second IBTR, including the breast cancer subtype of IBTR defined by the estrogen receptor (ER) and HER2 status, were assessed.
The median follow-up period was 62 months. The 5-year second IBTR-free survival rate was 83%. Patients with the ER-positive/HER2-negative subtype of IBTR had a significantly better second IBTR-free survival rate than those with other subtypes of IBTR (88% vs. 75%, respectively, p=0.02). Multivariate analysis revealed that the breast cancer subtype of IBTR was a significantly independent predictive factor of second IBTR-free survival (p=0.003). A low-risk group for second IBTR, defined by the breast cancer subtype of IBTR and margin status of primary surgery, was detected (5-year second IBTR-free survival rate: 100%).
Patients in the low-risk group defined by the breast cancer subtype of IBTR and margin status of primary surgery could safely undergo repeat lumpectomy without radiotherapy for IBTR.
对于同侧乳腺肿瘤复发（IBTR）行挽救性手术后接受再次保乳手术且未进行放疗的患者，其局部复发风险的相关信息较少。
对65例IBTR后接受再次保乳手术且未进行放疗的患者进行回顾性分析。评估第二次IBTR的危险因素，包括根据雌激素受体（ER）和HER2状态定义的IBTR的乳腺癌亚型。
中位随访期为62个月。5年无第二次IBTR生存率为83%。IBTR为ER阳性/HER2阴性亚型的患者，其无第二次IBTR生存率显著高于其他IBTR亚型的患者（分别为88%和75%，p=0.02）。多因素分析显示，IBTR的乳腺癌亚型是无第二次IBTR生存的显著独立预测因素（p=0.003）。根据IBTR的乳腺癌亚型和初次手术切缘状态确定了一个第二次IBTR低风险组（5年无第二次IBTR生存率：100%）。
根据IBTR的乳腺癌亚型和初次手术切缘状态定义的低风险组患者，可安全地接受IBTR再次保乳手术且无需放疗。
