Department of Gynecology, Obstetrics and Reproductive Medicine, University Hospital Medical School, Kirrbergerstraße 100, 66421, Homburg/Saar, Germany.
Department of Radiation Oncology, University Hospital Medical School, Homburg, Germany.
Arch Gynecol Obstet. 2019 Aug;300(2):365-376. doi: 10.1007/s00404-019-05220-x. Epub 2019 Jun 20.
There is widespread consent that isolated locoregional recurrence (ILRR) in breast cancer should be treated surgically. On searching literature and guidelines most studies include ipsilateral recurrence in breast tissue or on thoracic wall post-mastectomy, recurrence in scar tissue as well as in ipsilateral axillary lymph nodes. Some studies discuss metachronous contralateral breast cancer as ILRR. About 10-35% of women with primary breast cancer suffer from ILRR. The existing data concerning the role of systemic therapy in the treatment of ILRR are insufficient. We investigated the influence of chemotherapy on disease-free- (DFS) and overall-survival (OS).
Retrospective analysis of all patients with ILRR and without distant metastasis was done, which were treated at the Department of Gynecology, Obstetrics and Reproductive Medicine, Saarland University between 2005 and 2013. Data collection used patients' database system and was followed via patient questionnaires.
In total, we collected data of 93 patients with locally recurrent breast cancer and observed a 72.6% questionnaire response rate. Average timeline accounted for 99 months between primary diagnosis and local recurrence; average age of patients at diagnosis of local recurrence was 60.6 years. After a median follow-up of 63 months DFS reached 76% with and 73% without chemotherapy, and after 74 months overall survival amounted to 94% and 70%, respectively.
Almost all patients with ILRR were operated. Especially patients with hormone receptor-negative recurrent breast cancer seemed to show a benefit having been treated with chemotherapy. Most patients were without recurrence after their particular therapies.
广泛认为乳腺癌孤立局部区域复发(ILRR)应通过手术治疗。在搜索文献和指南时,大多数研究都包括乳腺癌组织或胸壁切除术后同侧复发、疤痕组织以及同侧腋窝淋巴结复发。一些研究将异时性对侧乳腺癌作为 ILRR 进行讨论。约 10-35%的原发性乳腺癌患者患有 ILRR。关于全身治疗在治疗 ILRR 中的作用的现有数据不足。我们研究了化疗对无病生存(DFS)和总生存(OS)的影响。
对 2005 年至 2013 年期间在萨尔兰大学妇科、产科和生殖医学系接受治疗的所有 ILRR 且无远处转移的患者进行回顾性分析。使用患者数据库系统收集数据,并通过患者问卷调查进行随访。
共收集了 93 例局部复发性乳腺癌患者的数据,问卷应答率为 72.6%。从原发性诊断到局部复发的平均时间线为 99 个月;局部复发时患者的平均年龄为 60.6 岁。在中位随访 63 个月时,DFS 达到 76%的患者和无化疗的患者为 73%,在 74 个月时,OS 分别为 94%和 70%。
几乎所有 ILRR 患者都接受了手术治疗。特别是激素受体阴性复发性乳腺癌患者似乎从化疗治疗中受益。大多数患者在接受特定治疗后无复发。