Local recurrence in breast cancer: Implications for systemic disease |
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Authors: | Dr Lisa D Curcio MD David Z J Chu MD Chul Ahn PhD Wydell L Williams Jr MD I Benjamin Paz MD Daniel Riihimaki MD Joshua D I Ellenhorn MD Lawrence Wagman MD |
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Institution: | (1) From the Departments of General and Oncologic Surgery and Biostatistics, City of Hope National Medical Center, Duarte, California, USA |
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Abstract: | Background: Recurrence in breast carcinoma follows a pattern of growth marked by local, regional, or widespread dissemination. Local
recurrence may be the harbinger of systemic disease or failure of local control. Delineation of these processes may have implications
in treatment.
Methods: A retrospective review found 1,171 patients with stages I and II breast cancer from 1978 to 1990 treated at the City of Hope
Medical Center.
Results: Twenty-seven percent (n=313) of patients developed recurrences. These were classified as local, including chest wall and
regional nodes (n=40), local and distant (n=63), and distant (n=210). Mean follow-up was 60 months. Multivariate analysis
demonstrates tumor size was not different between the three groups, but the presence of positive lymph nodes was: local=51%,
local and distant=78%, and distant=64%. The disease-free interval was longest in the local group (42 months) versus the local
and distant group (23 months) and distant group (39 months). Median survival was calculated from the time of recurrence: local=90
months, local and distant=26 months, and distant=16 months.
Conclusions: A group of patients with local recurrence have improved survival and do not develop distant disease. This group may benefit
from aggressive surgical treatment to control local disease. These data suggest that a subset of breast tumors can act locally
aggressive without metastatic potential.
Presented at the 48th Annual Cancer Symposium of The Society of Surgical Oncology, Boston, Massachusetts, March 23–26, 1995. |
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Keywords: | Breast cancer Recurrence prognosis Survival |
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