Orit Kaidar-Person1,2, Philip Poortmans3,4, Birgitte Vrou Offersen5, Sabine Siesling6,7, Miri Sklair-Levy8,9, Icro Meattini10, Dirk de Ruysscher11, Thorsten Kühn12, Liesbeth J Boersma11. 1. Breast Radiation Therapy Unit, Sheba Medical Center, Sheba Tel Ha'shomer, Ramat Gan, Israel. Orit.kaidarperson@sheba.health.gov.il. 2. GROW-School for Oncology and Developmental Biology or GROW (Maastro), Maastricht University, Maastricht, The Netherlands. Orit.kaidarperson@sheba.health.gov.il. 3. Iridium Kankernetwerk, Wilrijk, 2610, Antwerp, Belgium. 4. Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Wilrijk-Antwerp, Belgium. 5. Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark. 6. Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. 7. Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands. 8. Meirav Breast Center, Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat Gan, Israel. 9. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. 10. Department of Experimental and Clinical Biomedical Sciences "M. Serio", University of Florence, Florence, Italy. 11. Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. 12. Department of Gynaecology and Obstetrics, Interdisciplinary Breast Center, Klinikum Esslingen, Esslingen, Germany.
Abstract
PURPOSE: We performed a systematic review to document the spatial location of local recurrences (LR) after mastectomy. METHODS: A PubMed search was conducted in August 2019 for the following terms: breast [Title/Abstract] AND cancer [Title/Abstract] AND recurrence [Title/Abstract] AND mastectomy [Title/Abstract]. The search was filtered for English language. Exclusion criteria included studies that did not specify the LR location or studies reporting LR associated with inflammatory breast cancer, or other breast cancers such as phyllodes tumours, lymphoma or associated with sarcoma/angiosarcoma. RESULTS: A total of 3922 titles were identified, of which 21 publications were eligible for inclusion in the final analysis. A total of 6901 mastectomy patients were included (range 25-1694). The mean LR proportion was 3.5%. Among the total of 351 LR lesions, 81.8% were in the subcutaneous tissue and the skin, while 16% were pectoral muscle recurrences. CONCLUSION: Local recurrences are mostly located within the subcutaneous tissue and the skin, assumed to result from unrecognized/subclinical tumour foci left behind after mastectomy, surgical implantation of tumour cells in the wound/scar and/or tumour emboli within the subcutaneous lymphatics. Pectoral muscle recurrences are less frequent and may be attributed to residual disease along the posterior surgical margin and/or lymphatic involvement.
PURPOSE: We performed a systematic review to document the spatial location of local recurrences (LR) after mastectomy. METHODS: A PubMed search was conducted in August 2019 for the following terms: breast [Title/Abstract] AND cancer [Title/Abstract] AND recurrence [Title/Abstract] AND mastectomy [Title/Abstract]. The search was filtered for English language. Exclusion criteria included studies that did not specify the LR location or studies reporting LR associated with inflammatory breast cancer, or other breast cancers such as phyllodes tumours, lymphoma or associated with sarcoma/angiosarcoma. RESULTS: A total of 3922 titles were identified, of which 21 publications were eligible for inclusion in the final analysis. A total of 6901 mastectomy patients were included (range 25-1694). The mean LR proportion was 3.5%. Among the total of 351 LR lesions, 81.8% were in the subcutaneous tissue and the skin, while 16% were pectoral muscle recurrences. CONCLUSION: Local recurrences are mostly located within the subcutaneous tissue and the skin, assumed to result from unrecognized/subclinical tumour foci left behind after mastectomy, surgical implantation of tumour cells in the wound/scar and/or tumour emboli within the subcutaneous lymphatics. Pectoral muscle recurrences are less frequent and may be attributed to residual disease along the posterior surgical margin and/or lymphatic involvement.
Entities:
Keywords:
Breast cancer; Breast reconstruction; Local recurrence; Mastectomy; Nipple sparing; Skin sparing
Authors: Nicholas Lao; Muriel Brackstone; Silvia C Formenti; Christopher Doherty; Francisco Perera; Ronald Chow; Tanya DeLyzer; Aaron Grant; Gabriel Boldt; Michael Lock Journal: Clin Transl Radiat Oncol Date: 2021-05-06