Lokaal recidief na borstsparende behandeling wegens mammacarcinoom; behandeling en prognose bij 82 patiënten

To evaluate the treatment and prognosis of 82 patients with local relapse in the breast as the first event after breast-conserving therapy of operable breast cancer.

Design

Descriptive and retrospective.

Setting

17 general hospitals in southeast North-Brabant and North-Limburg.

Methods

Using the registries of the Comprehensive Cancer Centre South in Eindhoven (1981-1990) and the Bernard Verbeeten Institute in Tilburg (1981-1987), 82 patients were identified who had developed local recurrence after breast-conserving therapy.

Results

The mean age of the 82 patients at the time of detection of local recurrence was 51 years. 46 recurrences (56) were localized at or near the site of the original tumour, 14 (17) were detected elsewhere in the breast, 15 (18) showed diffuse spread through the breast and seven (9) were completely or partly localized in the skin. Nine recurrences (11) were non-invasive. Of the 82 patients four received adjuvant systemic therapy only and no surgery. Of the 78 patients treated with surgery 72 underwent mastectomy, 6 local excision. After treatment, the actuarial five-year overall survival, distant recurrence-free survival and disease-free survival rates were 60, 43 and 31 respectively. Local control, defined as survival without second local recurrence and without local progression of the disease, was 57 after five years.

Conclusion

The five-year distant recurrence-free and disease-free survival rates for patients with local recurrence after breast conserving-therapy were low. The high proportion of second local recurrences and local progression of disease in this study underlines the difficulty of obtaining local control after treatment of local recurrence.