Hartup Sue M, Morgan Jenna L, Cheng Vinton Wt, Barry Peter A, Copson Ellen, Cutress Ramsey I, Dave Rajiv, Elsberger Beatrix, Fairbrother Patricia, Hogan Brian, Horgan Kieran, Kirwan Cliona C, McIntosh Stuart A, O'Connell Rachel L, Patani Neill, Potter Shelley, Rattay Tim, Sheehan Lisa, Wyld Lynda, Kim Baek
The Breast Unit at the Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds.
Division of Clinical Medicine, University of Sheffield School of Medicine and Population Health, Beech Hill Road, Sheffield.
Int J Surg Protoc. 2024 Jan 26;28(1):20-26. doi: 10.1097/SP9.0000000000000018. eCollection 2024 Mar.
Despite a UK 5-year breast cancer survival rate of 86.6%, patients may develop breast cancer recurrence within the same breast after breast conserving surgery, as well as in the remaining skin or chest wall after mastectomy or in the ipsilateral lymph glands. These recurrences, collectively termed locoregional recurrence (LRR), occur in around 8% of patients within 10 years of their original diagnosis. Currently, there is a lack of robust information on the presentation and prevalence of LRR with no UK-specific clinical guidelines available for the optimal management of this patient group. Additionally, there is a need to identify patterns of LRR presentation and their progression, which will enable prognostic factors to be determined. This will subsequently enable the tailoring of treatment and improve patient outcome.
The MARECA study is a prospective, multicentre cohort study recruiting patients diagnosed with breast cancer LRR +/- associated distant metastases. Over 50 UK breast units are participating in the study with the aim of recruiting at least 500 patients over a recruitment period of 24 months. The data collected will detail the tumour pathology, imaging results, surgical treatment, radiotherapy and systemic therapy of the primary and recurrent breast cancer. Study follow-up will be for up to 5 years following LRR diagnosis to determine subsequent oncological outcomes and evaluate potential prognostic factors.
This study will address the current knowledge gap and identify subgroups of patients who have less successful treatment outcomes. The results will determine the current management of LRR and the prognosis of patients diagnosed with breast cancer LRR +/- distant metastases in the UK, with the aim of establishing best practice and informing future national guidelines. The results will direct future research and inform the design of additional interventional trials and translational studies.
尽管英国乳腺癌患者的5年生存率为86.6%，但保乳手术后患者仍可能在同侧乳房复发乳腺癌，乳房切除术后也可能在剩余皮肤或胸壁复发，或在同侧淋巴结复发。这些复发统称为局部区域复发（LRR），约8%的患者在初次诊断后的10年内会出现。目前，关于LRR的表现和患病率缺乏有力信息，且没有针对该患者群体最佳管理的英国特定临床指南。此外，需要确定LRR的表现模式及其进展情况，这将有助于确定预后因素。这随后将使治疗方案更具针对性并改善患者预后。
MARECA研究是一项前瞻性、多中心队列研究，招募被诊断为LRR±伴有远处转移的乳腺癌患者。英国50多个乳腺科参与了该研究，目标是在24个月的招募期内至少招募500名患者。收集的数据将详细记录原发性和复发性乳腺癌的肿瘤病理学、影像学结果、手术治疗、放疗和全身治疗情况。研究随访将在LRR诊断后持续5年，以确定后续的肿瘤学结局并评估潜在的预后因素。
本研究将填补当前的知识空白，识别治疗效果较差的患者亚组。研究结果将确定英国LRR的当前管理情况以及被诊断为LRR±伴有远处转移的乳腺癌患者的预后情况，目的是确立最佳实践并为未来的国家指南提供信息。研究结果将指导未来的研究，并为额外的干预试验和转化研究的设计提供信息。
