[Local recurrence following breast-conserving treatment for breast carcinoma; treatment and prognosis in 82 patients]. / Lokaal recidief na borstsparende behandeling wegens mammacarcinoom; behandeling en prognose bij 82 patiënten.

ABSTRACT

OBJECTIVE: 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.