Management of ipsilateral breast tumor recurrence following breast conservation surgery: a comparative study of re-conservation vs mastectomy
Background Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tum...
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| Veröffentlicht in: | Breast cancer research and treatment 2021-05, Vol.187 (1), p.105-112 |
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| creator | Van den Bruele, Astrid Botty Chen, Ishita Sevilimedu, Varadan Le, Tiana Morrow, Monica Braunstein, Lior Z. Cody, Hiram S. |
| description | Background
Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tumor recurrence (IBTR), for whom mastectomy is generally recommended.
Methods
We identified women who underwent BCT for invasive or ductal carcinoma in situ and developed IBTR as a first event, comparing the pattern of subsequent events and survival for those treated by RCT versus mastectomy.
Results
Of 16,968 patents who had BCT, 322 (1.9%) developed an isolated IBTR as a first event between 1999 and 2019. 130 (40%) had RCT and 192 (60%) mastectomy. Compared to mastectomy, the RCT patients were older (66 vs 53, |
| doi_str_mv | 10.1007/s10549-020-06080-9 |
| format | Article |
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Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tumor recurrence (IBTR), for whom mastectomy is generally recommended.
Methods
We identified women who underwent BCT for invasive or ductal carcinoma in situ and developed IBTR as a first event, comparing the pattern of subsequent events and survival for those treated by RCT versus mastectomy.
Results
Of 16,968 patents who had BCT, 322 (1.9%) developed an isolated IBTR as a first event between 1999 and 2019. 130 (40%) had RCT and 192 (60%) mastectomy. Compared to mastectomy, the RCT patients were older (66 vs 53, < 0.001), had a longer disease-free interval (DFI: 5.8 vs 2.7 years (
p
< 0.001)), were less likely to have received RT (
p
< 0.001), endocrine therapy (ET) (
p
< 0.005) or combined RT/ET (< 0.001) as initial treatment, but the characteristics of their initial primary cancers and of their IBTR were comparable. At a median follow-up of 10.7 years following initial BCT and 6.5 years following IBTR, there were no differences in BCSS or OS between RCT and mastectomy.
Conclusion
For BCT patients who developed IBTR as a first event, we observed comparable BCSS and OS from time of initial treatment and from time of IBTR, whether treated by RCT or mastectomy. These results support wider consideration of RCT in the management of IBTR, especially in the setting of older age and longer DFI.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-020-06080-9</identifier><identifier>PMID: 33433775</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Breast cancer ; Breast Neoplasms - epidemiology ; Breast Neoplasms - surgery ; Cancer research ; Cancer therapies ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Care and treatment ; Clinical Trial ; Diseases ; Endocrine therapy ; Female ; Humans ; Invasiveness ; Life Sciences & Biomedicine ; Lumpectomy ; Mastectomy ; Mastectomy, Segmental ; Medical research ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - surgery ; Oncology ; Patients ; Reconstructive surgery ; Relapse ; Science & Technology ; Surgery ; Tumors ; Womens health</subject><ispartof>Breast cancer research and treatment, 2021-05, Vol.187 (1), p.105-112</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>10</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000607334100001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c572t-4d0f1a56a436b799bf54c36e8b03a6e1388abd79796bf8b90fcbff15fac64a7d3</citedby><cites>FETCH-LOGICAL-c572t-4d0f1a56a436b799bf54c36e8b03a6e1388abd79796bf8b90fcbff15fac64a7d3</cites><orcidid>0000-0002-5346-0532</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-020-06080-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-020-06080-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,315,782,786,887,27931,27932,39265,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33433775$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van den Bruele, Astrid Botty</creatorcontrib><creatorcontrib>Chen, Ishita</creatorcontrib><creatorcontrib>Sevilimedu, Varadan</creatorcontrib><creatorcontrib>Le, Tiana</creatorcontrib><creatorcontrib>Morrow, Monica</creatorcontrib><creatorcontrib>Braunstein, Lior Z.</creatorcontrib><creatorcontrib>Cody, Hiram S.</creatorcontrib><title>Management of ipsilateral breast tumor recurrence following breast conservation surgery: a comparative study of re-conservation vs mastectomy</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>BREAST CANCER RES TR</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Background
Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tumor recurrence (IBTR), for whom mastectomy is generally recommended.
Methods
We identified women who underwent BCT for invasive or ductal carcinoma in situ and developed IBTR as a first event, comparing the pattern of subsequent events and survival for those treated by RCT versus mastectomy.
Results
Of 16,968 patents who had BCT, 322 (1.9%) developed an isolated IBTR as a first event between 1999 and 2019. 130 (40%) had RCT and 192 (60%) mastectomy. Compared to mastectomy, the RCT patients were older (66 vs 53, < 0.001), had a longer disease-free interval (DFI: 5.8 vs 2.7 years (
p
< 0.001)), were less likely to have received RT (
p
< 0.001), endocrine therapy (ET) (
p
< 0.005) or combined RT/ET (< 0.001) as initial treatment, but the characteristics of their initial primary cancers and of their IBTR were comparable. At a median follow-up of 10.7 years following initial BCT and 6.5 years following IBTR, there were no differences in BCSS or OS between RCT and mastectomy.
Conclusion
For BCT patients who developed IBTR as a first event, we observed comparable BCSS and OS from time of initial treatment and from time of IBTR, whether treated by RCT or mastectomy. These results support wider consideration of RCT in the management of IBTR, especially in the setting of older age and longer DFI.</description><subject>Aged</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Carcinoma, Ductal</subject><subject>Carcinoma, Intraductal, Noninfiltrating</subject><subject>Care and treatment</subject><subject>Clinical Trial</subject><subject>Diseases</subject><subject>Endocrine therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Invasiveness</subject><subject>Life Sciences & Biomedicine</subject><subject>Lumpectomy</subject><subject>Mastectomy</subject><subject>Mastectomy, Segmental</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Oncology</subject><subject>Patients</subject><subject>Reconstructive surgery</subject><subject>Relapse</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Tumors</subject><subject>Womens health</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>HGBXW</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkl-L1DAUxYso7rr6BXyQguCLdE2aJml9EJbBf7Diiz6HNL2ZydImY5LOMh_C7-ydnd3ZHRCRPARuf-c093CK4iUl55QQ-S5RwpuuIjWpiCAtqbpHxSnlklWypvJxcUqokJVoiTgpnqV0RQjpJOmeFieMNYxJyU-L39-010uYwOcy2NKtkxt1hqjHso-gUy7zPIVYRjBzjOANlDaMY7h2fnlHmOATxI3OLvgyzXEJcfu-1Dif1jrieANlyvOw3f0hQnXEb1I5oQmYHKbt8-KJ1WOCF7f3WfHz08cfiy_V5ffPXxcXl5Xhss5VMxBLNRe6YaKXXddb3hgmoO0J0wIoa1vdD7KTneht23fEmt5ayq02otFyYGfFh73veu4nGAxujxurdXSTjlsVtFPHX7xbqWXYKMyyFQ1Fg9e3BjH8miFldRXm6PHNquZU8E5yyu6ppR5BOW8DmpnJJaMukGl4zVuJ1PlfKDwDTA6zAutwfiR480CwAj3mVQrjvMszHYP1HjQxpBTBHjakRO0qpPYVUlghdVMh1aHo1cNsDpK7ziDwdg9cQx9sMm7XigOGJRNEIoz-hOySav-fXrh804pFmH1GKdtLE-IeW3Uf8j_e_wdIV_Xz</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Van den Bruele, Astrid Botty</creator><creator>Chen, Ishita</creator><creator>Sevilimedu, Varadan</creator><creator>Le, Tiana</creator><creator>Morrow, Monica</creator><creator>Braunstein, Lior Z.</creator><creator>Cody, Hiram S.</creator><general>Springer US</general><general>Springer Nature</general><general>Springer</general><general>Springer Nature B.V</general><scope>BLEPL</scope><scope>DTL</scope><scope>HGBXW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5346-0532</orcidid></search><sort><creationdate>20210501</creationdate><title>Management of ipsilateral breast tumor recurrence following breast conservation surgery: a comparative study of re-conservation vs mastectomy</title><author>Van den Bruele, Astrid Botty ; Chen, Ishita ; Sevilimedu, Varadan ; Le, Tiana ; Morrow, Monica ; Braunstein, Lior Z. ; Cody, Hiram S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c572t-4d0f1a56a436b799bf54c36e8b03a6e1388abd79796bf8b90fcbff15fac64a7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Carcinoma, Ductal</topic><topic>Carcinoma, Intraductal, Noninfiltrating</topic><topic>Care and treatment</topic><topic>Clinical Trial</topic><topic>Diseases</topic><topic>Endocrine therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Invasiveness</topic><topic>Life Sciences & Biomedicine</topic><topic>Lumpectomy</topic><topic>Mastectomy</topic><topic>Mastectomy, Segmental</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Oncology</topic><topic>Patients</topic><topic>Reconstructive surgery</topic><topic>Relapse</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Tumors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van den Bruele, Astrid Botty</creatorcontrib><creatorcontrib>Chen, Ishita</creatorcontrib><creatorcontrib>Sevilimedu, Varadan</creatorcontrib><creatorcontrib>Le, Tiana</creatorcontrib><creatorcontrib>Morrow, Monica</creatorcontrib><creatorcontrib>Braunstein, Lior Z.</creatorcontrib><creatorcontrib>Cody, Hiram S.</creatorcontrib><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Web of Science - Science Citation Index Expanded - 2021</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van den Bruele, Astrid Botty</au><au>Chen, Ishita</au><au>Sevilimedu, Varadan</au><au>Le, Tiana</au><au>Morrow, Monica</au><au>Braunstein, Lior Z.</au><au>Cody, Hiram S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of ipsilateral breast tumor recurrence following breast conservation surgery: a comparative study of re-conservation vs mastectomy</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><stitle>BREAST CANCER RES TR</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>187</volume><issue>1</issue><spage>105</spage><epage>112</epage><pages>105-112</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Background
Breast conservation therapy (BCT) is well established for the management of primary operable breast cancer, with oncologic outcomes comparable to those of mastectomy. It remains unclear whether re-conservation therapy (RCT) is suitable for those patients who develop ipsilateral breast tumor recurrence (IBTR), for whom mastectomy is generally recommended.
Methods
We identified women who underwent BCT for invasive or ductal carcinoma in situ and developed IBTR as a first event, comparing the pattern of subsequent events and survival for those treated by RCT versus mastectomy.
Results
Of 16,968 patents who had BCT, 322 (1.9%) developed an isolated IBTR as a first event between 1999 and 2019. 130 (40%) had RCT and 192 (60%) mastectomy. Compared to mastectomy, the RCT patients were older (66 vs 53, < 0.001), had a longer disease-free interval (DFI: 5.8 vs 2.7 years (
p
< 0.001)), were less likely to have received RT (
p
< 0.001), endocrine therapy (ET) (
p
< 0.005) or combined RT/ET (< 0.001) as initial treatment, but the characteristics of their initial primary cancers and of their IBTR were comparable. At a median follow-up of 10.7 years following initial BCT and 6.5 years following IBTR, there were no differences in BCSS or OS between RCT and mastectomy.
Conclusion
For BCT patients who developed IBTR as a first event, we observed comparable BCSS and OS from time of initial treatment and from time of IBTR, whether treated by RCT or mastectomy. These results support wider consideration of RCT in the management of IBTR, especially in the setting of older age and longer DFI.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33433775</pmid><doi>10.1007/s10549-020-06080-9</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5346-0532</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Online Journals Complete; Web of Science - Science Citation Index Expanded - 2021<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /> |
| subjects | Aged Breast cancer Breast Neoplasms - epidemiology Breast Neoplasms - surgery Cancer research Cancer therapies Carcinoma, Ductal Carcinoma, Intraductal, Noninfiltrating Care and treatment Clinical Trial Diseases Endocrine therapy Female Humans Invasiveness Life Sciences & Biomedicine Lumpectomy Mastectomy Mastectomy, Segmental Medical research Medicine Medicine & Public Health Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - surgery Oncology Patients Reconstructive surgery Relapse Science & Technology Surgery Tumors Womens health |
| title | Management of ipsilateral breast tumor recurrence following breast conservation surgery: a comparative study of re-conservation vs mastectomy |
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