Jan Jobsen1, Job van der Palen2, Sietske Riemersma3, Harald Heijmans4, Francisca Ong5, Henk Struikmans6. 1. Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: j.jobsen@mst.nl. 2. Department of Epidemiology, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement, and Data Analysis, Faculty of Behavioral Science, University of Twente, Enschede, The Netherlands. 3. Laboratory for Pathology Oost Nederland, Hengelo, The Netherlands. 4. Department of Surgery, Ziekenhuis Groep Twente, Hengelo, The Netherlands. 5. Department of Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands. 6. Department of Radiation Oncology, Leiden University Medical Centre, Leiden, The Netherlands; Radiotherapy Centre West, Medical Centre Haaglanden, The Hague, The Netherlands.
Abstract
PURPOSE: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. METHODS AND MATERIALS: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. RESULTS: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. CONCLUSIONS: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.
PURPOSE: To analyze the incidence and prognostic factors of ipsilateral breast tumor recurrence (IBTR) after breast-conserving therapy (BCT) in a large, population-based, single-center study with long-term follow-up. METHODS AND MATERIALS: We analyzed 3595 cases in which BCT was performed in 3824 women with stage I or II breast cancer. The incidence of IBTR was analyzed over time and was based on IBTR as first event. RESULTS: The 15-year local relapse-free survival was 90.9%. The hazard estimates for IBTR showed a time course with 2 peaks, the first at approximately 5 years and the second, twice as high, at 12 years. Stratifying subjects by age and margin status showed that, for women ≤40 years old with negative margins, adjuvant systemic therapy led to a 5-fold reduced risk of recurrence compared to none, and the presence of lymph vascular space invasion (LVSI) had a 3-fold increased risk compared to its absence. For women >40 years old, the presence of LVSI (hazard ratio [HR] 2.5) and the presence of lobular carcinoma in situ in the lumpectomy specimen (HR 2.3) were the only 2 risk factors. CONCLUSIONS: We demonstrated a pattern in risk of IBTR over time, with 2 peaks, first at approximately 5 years and a second, much higher peak at approximately 12 years, especially for women ≤40 years old. For women ≤40 years old with tumor-free resection margins, we noted that the absence of adjuvant systemic therapy and the presence of LVSI were independent prognostic factors of IBTR. For women >40 years old, the presence of LVSI and the presence of lobular carcinoma in situ were independent risk factors.
Authors: Faina Nakhlis; Fisher D Katlin; Samantha C Grossmith; Ashley DiPasquale; Beth T Harrison; Stuart J Schnitt; Tari A King Journal: Ann Surg Oncol Date: 2022-06-30 Impact factor: 4.339
Authors: Willemina R R Geurts-Giele; Victorien M T van Verschuer; Carolien H M van Deurzen; Paul J van Diest; Rute M S M Pedrosa; J Margriet Collée; Linetta B Koppert; Caroline Seynaeve; Winand N M Dinjens Journal: Mod Pathol Date: 2016-09-09 Impact factor: 7.842
Authors: James R Bundred; Sarah Michael; Beth Stuart; Ramsey I Cutress; Kerri Beckmann; Bernd Holleczek; Jane E Dahlstrom; Jacqui Gath; David Dodwell; Nigel J Bundred Journal: BMJ Date: 2022-09-21