PURPOSE: To evaluate the prognostic significance of ipsilateral breast tumor recurrence (IBTR) with respect to the subsequent development of distant metastasis. MATERIALS AND METHODS: Between January 1970 and December 1989, 973 patients with invasive breast cancer were treated with conservative surgery and radiation therapy at Yale-New Haven Hospital. The median follow-up time as of December 1993 was 8.6 years. A number of prognostic factors were tested as possible predictors of distant metastases, including whether a patient experienced IBTR. IBTRs were broken down by time to recurrence to determine whether the breast recurrence-free interval had any prognostic relevance with respect to the development of distant metastasis. RESULTS: As of December 1993, out of the entire population of 973 patients, 73 patients had developed IBTR and 134 had developed distant metastases. The overall actuarial survival rate at 10 years was .71 +/- .02, with a 10-year actuarial breast recurrence-free rate of .84 +/- .02 and a 10-year distant metastasis-free rate of .77 +/- .02. The overall distant metastasis rate was higher in patients who experienced IBTR compared with patients who had never experienced IBTR. Furthermore, the time to IBTR had a significant effect on distant metastases. Of 32 patients who developed an IBTR within 4 years of original diagnosis, 16 (50%) developed distant metastases. In contrast, of 41 patients who developed later breast relapses (> 4 years from original diagnosis), only seven (17%) developed distant metastases (P < .01). Of 32 patients who developed early breast relapse, the 5-year survival rate following breast relapse was .50 +/- .01, compared with a 5-year post-breast relapse survival rate of .78 +/- .10 among 41 patients with later breast relapses (P < .05). CONCLUSION: It appears that early IBTR is a significant predictor for distant metastases. Whether early breast tumor relapse is a marker for or cause of distant metastases remains a controversial and unresolved issue. Implications for adjuvant systemic therapy at the time of breast relapse are discussed.
PURPOSE: To evaluate the prognostic significance of ipsilateral breast tumor recurrence (IBTR) with respect to the subsequent development of distant metastasis. MATERIALS AND METHODS: Between January 1970 and December 1989, 973 patients with invasive breast cancer were treated with conservative surgery and radiation therapy at Yale-New Haven Hospital. The median follow-up time as of December 1993 was 8.6 years. A number of prognostic factors were tested as possible predictors of distant metastases, including whether a patient experienced IBTR. IBTRs were broken down by time to recurrence to determine whether the breast recurrence-free interval had any prognostic relevance with respect to the development of distant metastasis. RESULTS: As of December 1993, out of the entire population of 973 patients, 73 patients had developed IBTR and 134 had developed distant metastases. The overall actuarial survival rate at 10 years was .71 +/- .02, with a 10-year actuarial breast recurrence-free rate of .84 +/- .02 and a 10-year distant metastasis-free rate of .77 +/- .02. The overall distant metastasis rate was higher in patients who experienced IBTR compared with patients who had never experienced IBTR. Furthermore, the time to IBTR had a significant effect on distant metastases. Of 32 patients who developed an IBTR within 4 years of original diagnosis, 16 (50%) developed distant metastases. In contrast, of 41 patients who developed later breast relapses (> 4 years from original diagnosis), only seven (17%) developed distant metastases (P < .01). Of 32 patients who developed early breast relapse, the 5-year survival rate following breast relapse was .50 +/- .01, compared with a 5-year post-breast relapse survival rate of .78 +/- .10 among 41 patients with later breast relapses (P < .05). CONCLUSION: It appears that early IBTR is a significant predictor for distant metastases. Whether early breast tumor relapse is a marker for or cause of distant metastases remains a controversial and unresolved issue. Implications for adjuvant systemic therapy at the time of breast relapse are discussed.
Authors: Laura L Michel; Laura Sommer; Rosa González Silos; Justo Lorenzo Bermejo; Alexandra von Au; Julia Seitz; André Hennigs; Katharina Smetanay; Michael Golatta; Jörg Heil; Florian Schütz; Christof Sohn; Andreas Schneeweiss; Frederik Marmé Journal: Breast Cancer Res Treat Date: 2019-06-24 Impact factor: 4.872
Authors: Min Yi; Thomas A Buchholz; Funda Meric-Bernstam; Isabelle Bedrosian; Rosa F Hwang; Merrick I Ross; Henry M Kuerer; Sheng Luo; Ana M Gonzalez-Angulo; Aman U Buzdar; W Fraser Symmans; Barry W Feig; Anthony Lucci; Eugene H Huang; Kelly K Hunt Journal: Ann Surg Date: 2011-03 Impact factor: 12.969
Authors: A Neri; D Marrelli; S Rossi; A De Stefano; F Mariani; G De Marco; S Caruso; G Corso; T Cioppa; E Pinto; F Roviello Journal: World J Surg Date: 2007-01 Impact factor: 3.352
Authors: Stefan Aebi; Shari Gelber; Stewart J Anderson; István Láng; André Robidoux; Miguel Martín; Johan W R Nortier; Alexander H G Paterson; Mothaffar F Rimawi; José Manuel Baena Cañada; Beat Thürlimann; Elizabeth Murray; Eleftherios P Mamounas; Charles E Geyer; Karen N Price; Alan S Coates; Richard D Gelber; Priya Rastogi; Norman Wolmark; Irene L Wapnir Journal: Lancet Oncol Date: 2014-01-16 Impact factor: 41.316
Authors: Irene L Wapnir; Stefan Aebi; Shari Gelber; Stewart J Anderson; István Láng; André Robidoux; Eleftherios P Mamounas; Norman Wolmark Journal: Ann Surg Oncol Date: 2008-09-11 Impact factor: 5.344
Authors: Josef Hammer; Christine Track; Dietmar H Seewald; Kurt J Spiegl; Johannes Feichtinger; Andreas L Petzer; Werner Langsteger; Sabine Pöstlberger; Elisabeth Bräutigam Journal: Strahlenther Onkol Date: 2009-08-28 Impact factor: 3.621