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Prognosis Good for Local Recurrence After Lumpectomy

Prognosis Good for Local Recurrence After Lumpectomy

SAN ANTONIO—Patients who develop a local recurrence after conservative
surgery and radiation therapy for early-stage breast cancer generally have a
good long-term prognosis, particularly if treated with mastectomy, lead
researcher Sharon Galper, MD, told ONI. In this study, 59% of patients with a
local recurrence were alive at 10 years, said Dr. Galper, assistant professor
of radiation oncology, Brigham and Women’s Hospital, Dana-Farber Cancer
Institute, and Harvard Medical School.

Jay R. Harris, MD, chief of radiation oncology at Dana-Farber and professor
of radiation oncology at Harvard, presented the study results at the 24th
Annual San Antonio Breast Cancer Symposium (abstract 14).

From 1970 to 1987, 2,102 patients with clinical stage I/II breast cancer
were treated with complete excision and radiation therapy. Among these
patients, there were 318 local recurrences, defined as any recurrence within
the ipsilateral breast, with or without simultaneous regional nodal or distant
metastasis.

Patients were considered at risk for local recurrence until the occurrence
of distant metastases, contralateral breast cancer, or second nonbreast
malignancy. The final study population consisted of 288 patients.

The median time to local recurrence (the radiation therapy-local
recurrence interval) was 64.5 months (range, 1 to 220); median follow-up after
local recurrence was 95 months (range, 12 to 271); and median age at initial
diagnosis was 45 years (range, 25 to 88).

Local recurrence was noninvasive for 38 patients (13%), invasive for 225
(78%), and unknown for 25 (9%). Local therapy after local recurrence consisted
of mastectomy in 235 patients (82%), local excision with or without radiation
therapy in 22 (8%), and none in 31 (10%). Systemic therapy was given to 46% of
patients at the time of local recurrence.

Dr. Harris reported that of the 288 local recurrences, 268 occurred in
isolation, 5 with simultaneous opposite breast failure, and 15 with
simultaneous ipsilateral regional-nodal failure.

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