[Loco-regional recurrence following surgery of breast carcinoma: prognostic factors and therapeutic consequences].

The course following local relapse after mastectomy was studied prospectively in 225 women. Factors significantly influencing the further course were determined. On the whole the prognosis was relatively good, with a projected 5-year relapse-free survival of 47%, a median time interval of 53 months until development of distant metastases, and an estimated death rate of 41% after 5 years. The most important factor influencing the incidence and time interval until appearance of distant metastases is the axillary lymph node status at the time of mastectomy. N0 patients have a much better prognosis than N+ patients in univariate as well as multivariate analysis. Other factors in univariate analysis which play a role in either the incidence of distant metastases or overall survival include estrogen receptor content, site of the local relapse (skin or regional lymph nodes), time interval between mastectomy and the occurrence of the local relapse, and number of tumor nodules in the local relapse. In multivariate analysis virtually the only really independent prognostic factors are primarily the initial axillary lymph node status for survival free of distant metastases and the time interval from mastectomy to local relapse for overall survival.