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True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer
Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BC...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846390/ https://www.ncbi.nlm.nih.gov/pubmed/27158571 http://dx.doi.org/10.7759/cureus.541 |
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author | Sarsenov, Dauren Ilgun, Serkan Ordu, Cetin Alco, Gul Bozdogan, Atilla Elbuken, Filiz Nur Pilanci, Kezban Agacayak, Filiz Erdogan, Zeynep Eralp, Yesim Dincer, Maktav Ozmen, Vahit |
author_facet | Sarsenov, Dauren Ilgun, Serkan Ordu, Cetin Alco, Gul Bozdogan, Atilla Elbuken, Filiz Nur Pilanci, Kezban Agacayak, Filiz Erdogan, Zeynep Eralp, Yesim Dincer, Maktav Ozmen, Vahit |
author_sort | Sarsenov, Dauren |
collection | PubMed |
description | Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BCS) for early breast cancer (cT1-2/N0-1/M0) were evaluated. Demographic and pathologic parameters, radiologic data, treatment, and follow-up related features of the patients were recorded. Results: 53 patients (3.8%) had IBTR after BCS within a median follow-up of 70 months. The mean age was 45.7 years (range, 27-87 years), and 22 patients (41.5%) were younger than 40 years. 33 patients (62.3%) had true recurrence (TR) and 20 were classified as new primary (NP). The median time to recurrence was shorter in TR group than in NP group (37.0 (6-216) and 47.5 (11-192) months respectively; p = 0.338). Progesterone receptor positivity was significantly higher in the NP group (p = 0.005). The overall 5-year survival rate in the NP group (95.0%) was significantly higher than that of the TR group (74.7%, p < 0.033). Multivariate analysis showed that younger age (<40 years), large tumor size (>20 mm), high grade tumor and triple-negative molecular phenotype along with developing TR negatively affected overall survival (hazard ratios were 4.2 (CI 0.98-22.76), 4.6 (CI 1.07-13.03), 4.0 (CI 0.68-46.10), 6.5 (CI 0.03-0.68), and 6.5 (CI 0.02- 0.80) respectively, p < 0.05). Conclusions: Most of the local recurrences after BCS in our study were true recurrences, which resulted in a poorer outcome as compared to new primary tumors. Moreover, younger age (<40), large tumor size (>2 cm), high grade, triple negative phenotype, and having true recurrence were identified as independent prognostic factors with a negative impact on overall survival in this dataset of patients with recurrent breast cancer. In conjunction with a more intensive follow-up program, the role of adjuvant therapy strategies should be explored further in young patients with large and high-risk tumors to reduce the risk of TR. |
format | Online Article Text |
id | pubmed-4846390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-48463902016-05-06 True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer Sarsenov, Dauren Ilgun, Serkan Ordu, Cetin Alco, Gul Bozdogan, Atilla Elbuken, Filiz Nur Pilanci, Kezban Agacayak, Filiz Erdogan, Zeynep Eralp, Yesim Dincer, Maktav Ozmen, Vahit Cureus General Surgery Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BCS) for early breast cancer (cT1-2/N0-1/M0) were evaluated. Demographic and pathologic parameters, radiologic data, treatment, and follow-up related features of the patients were recorded. Results: 53 patients (3.8%) had IBTR after BCS within a median follow-up of 70 months. The mean age was 45.7 years (range, 27-87 years), and 22 patients (41.5%) were younger than 40 years. 33 patients (62.3%) had true recurrence (TR) and 20 were classified as new primary (NP). The median time to recurrence was shorter in TR group than in NP group (37.0 (6-216) and 47.5 (11-192) months respectively; p = 0.338). Progesterone receptor positivity was significantly higher in the NP group (p = 0.005). The overall 5-year survival rate in the NP group (95.0%) was significantly higher than that of the TR group (74.7%, p < 0.033). Multivariate analysis showed that younger age (<40 years), large tumor size (>20 mm), high grade tumor and triple-negative molecular phenotype along with developing TR negatively affected overall survival (hazard ratios were 4.2 (CI 0.98-22.76), 4.6 (CI 1.07-13.03), 4.0 (CI 0.68-46.10), 6.5 (CI 0.03-0.68), and 6.5 (CI 0.02- 0.80) respectively, p < 0.05). Conclusions: Most of the local recurrences after BCS in our study were true recurrences, which resulted in a poorer outcome as compared to new primary tumors. Moreover, younger age (<40), large tumor size (>2 cm), high grade, triple negative phenotype, and having true recurrence were identified as independent prognostic factors with a negative impact on overall survival in this dataset of patients with recurrent breast cancer. In conjunction with a more intensive follow-up program, the role of adjuvant therapy strategies should be explored further in young patients with large and high-risk tumors to reduce the risk of TR. Cureus 2016-03-24 /pmc/articles/PMC4846390/ /pubmed/27158571 http://dx.doi.org/10.7759/cureus.541 Text en Copyright © 2016, Sarsenov et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | General Surgery Sarsenov, Dauren Ilgun, Serkan Ordu, Cetin Alco, Gul Bozdogan, Atilla Elbuken, Filiz Nur Pilanci, Kezban Agacayak, Filiz Erdogan, Zeynep Eralp, Yesim Dincer, Maktav Ozmen, Vahit True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title | True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title_full | True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title_fullStr | True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title_full_unstemmed | True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title_short | True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer |
title_sort | true local recurrences after breast conserving surgery have poor prognosis in patients with early breast cancer |
topic | General Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846390/ https://www.ncbi.nlm.nih.gov/pubmed/27158571 http://dx.doi.org/10.7759/cureus.541 |
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