Comparison of Ipsilateral Breast Tumor Recurrence After Breast-conserving Surgery Between Ductal Carcinoma in Situ and Invasive Breast Cancer

Overview

Journal World J Surg Oncol

Publisher Biomed Central

Specialties General Surgery
Oncology

Date 2016 Apr 29

PMID 27122132

Citations 6

Authors

Young Jin Choi

Young Duck Shin

Young Jin Song

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to evaluate the differences in the rates and predictive factors for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery (BCS) between ductal carcinoma in situ (DCIS) and invasive breast cancer. And, we evaluated the impact of IBTR on overall survival and distant metastasis.

Methods: We retrospectively reviewed 322 consecutive patients with DCIS or invasive breast cancer who underwent BCS between 2004 and 2010. We evaluated the rates of IBTR of DCIS and invasive breast cancer. Univariate and multivariate analyses were performed to determine the predictive factors for IBTR, and survival rates were analyzed with Kaplan-Meier estimates.

Results: With a median follow-up period of 57 months, 5 (10%) out of 50 DCIS patients and 14 (5.1%) out of 272 invasive cancer patients had developed IBTR. Factors associated with IBTR on univariate and multivariate analyses were positive resection margin status in DCIS and omission of radiotherapy in invasive cancer, respectively. The hormone receptor negativity was strong independent predictive factors for IBTR in both DCIS and invasive breast cancer. Although the differences of survival curve did not reach statistical significance, the 5-year overall survival and distant metastasis-free survival of invasive cancer patients who suffered IBTR were inferior to those without (84 vs. 98% and 63.3 vs. 96.5%, respectively). Advanced initial stage, lymph node metastasis and experience of IBTR were associated with poor overall survival and distant metastasis on univariate and multivariate analyses.

Conclusions: The hormone receptor negativity was revealed as independent predictive factor for IBTR after BCS in both DCIS and invasive cancer. Experience of IBTR was independent prognostic factor for poor overall outcome in patients with invasive breast cancer. Aggressive local control and adjuvant therapy should be made in hormone receptor-negative patients who receive treatment with BCS.

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References

Tamura N, Tsuda H, Yoshida M, Hojo T, Akashi-Tanaka S, Kinoshita T . Clinicopathological predictive factors for ipsilateral and contralateral events following initial surgery to treat ductal carcinoma in situ. Breast Cancer. 2015; 23(3):510-8. PMC: 4839035. DOI: 10.1007/s12282-015-0595-x. View

Fisher E, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N . Fifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer. 2001; 91(8 Suppl):1679-87. View

Fisher B, Wickerham D, Deutsch M, Anderson S, Redmond C, Fisher E . Breast tumor recurrence following lumpectomy with and without breast irradiation: an overview of recent NSABP findings. Semin Surg Oncol. 1992; 8(3):153-60. View

Whelan T, Clark R, Roberts R, Levine M, Foster G . Ipsilateral breast tumor recurrence postlumpectomy is predictive of subsequent mortality: results from a randomized trial. Investigators of the Ontario Clinical Oncology Group. Int J Radiat Oncol Biol Phys. 1994; 30(1):11-6. DOI: 10.1016/0360-3016(94)90513-4. View

Haffty B, Reiss M, Beinfield M, Fischer D, Ward B, MCKHANN C . Ipsilateral breast tumor recurrence as a predictor of distant disease: implications for systemic therapy at the time of local relapse. J Clin Oncol. 1996; 14(1):52-7. DOI: 10.1200/JCO.1996.14.1.52. View

Silverstein M, LAGIOS M, Groshen S, Waisman J, Lewinsky B, Martino S . The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med. 1999; 340(19):1455-61. DOI: 10.1056/NEJM199905133401902. View

Karasawa K, Mitsumori M, Yamauchi C, Gomi K, Kataoka M, Uematsu T . Treatment outcome of breast-conserving therapy in patients with positive or close resection margins: Japanese multi institute survey for radiation dose effect. Breast Cancer. 2005; 12(2):91-8. DOI: 10.2325/jbcs.12.91. View

Yau T, Soong I, Chan K, Chan M, Cheung P, Lau H . Clinical outcome of breast conservation therapy for breast cancer in Hong Kong: prognostic impact of ipsilateral breast tumor recurrence and 2005 St. Gallen risk categories. Int J Radiat Oncol Biol Phys. 2007; 68(3):667-72. DOI: 10.1016/j.ijrobp.2006.12.043. View

Anderson S, Wapnir I, Dignam J, Fisher B, Mamounas E, Jeong J . Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 2009; 27(15):2466-73. PMC: 2684852. DOI: 10.1200/JCO.2008.19.8424. View

10.

Mechera R, Viehl C, Oertli D . Factors predicting in-breast tumor recurrence after breast-conserving surgery. Breast Cancer Res Treat. 2008; 116(1):171-7. DOI: 10.1007/s10549-008-0187-y. View

11.

Rudloff U, Brogi E, Reiner A, Goldberg J, Brockway J, Wynveen C . The influence of margin width and volume of disease near margin on benefit of radiation therapy for women with DCIS treated with breast-conserving therapy. Ann Surg. 2010; 251(4):583-91. DOI: 10.1097/SLA.0b013e3181b5931e. View

12.

Demicheli R, Ardoino I, Boracchi P, Coradini D, Agresti R, Ferraris C . Recurrence and mortality according to estrogen receptor status for breast cancer patients undergoing conservative surgery. Ipsilateral breast tumour recurrence dynamics provides clues for tumour biology within the residual breast. BMC Cancer. 2010; 10:656. PMC: 3002930. DOI: 10.1186/1471-2407-10-656. View

13.

Panet-Raymond V, Truong P, Alexander C, Lesperance M, McDonald R, Watson P . Clinicopathologic factors of the recurrent tumor predict outcome in patients with ipsilateral breast tumor recurrence. Cancer. 2011; 117(10):2035-43. DOI: 10.1002/cncr.25767. View

14.

Kim H, Han W, Yi O, Shin H, Ahn S, Koh B . Young age is associated with ipsilateral breast tumor recurrence after breast conserving surgery and radiation therapy in patients with HER2-positive/ER-negative subtype. Breast Cancer Res Treat. 2011; 130(2):499-505. DOI: 10.1007/s10549-011-1736-3. View

15.

Wang S, Chu H, Shamliyan T, Jalal H, M Kuntz K, Kane R . Network meta-analysis of margin threshold for women with ductal carcinoma in situ. J Natl Cancer Inst. 2012; 104(7):507-16. PMC: 3916966. DOI: 10.1093/jnci/djs142. View

16.

Lowery A, Kell M, Glynn R, Kerin M, Sweeney K . Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat. 2011; 133(3):831-41. DOI: 10.1007/s10549-011-1891-6. View

17.

Ishitobi M, Okumura Y, Arima N, Yoshida A, Nakatsukasa K, Iwase T . Breast cancer subtype and distant recurrence after ipsilateral breast tumor recurrence. Ann Surg Oncol. 2013; 20(6):1886-92. DOI: 10.1245/s10434-012-2825-1. View

18.

Vicini F, Shaitelman S, Wilkinson J, Shah C, Ye H, Kestin L . Long-term impact of young age at diagnosis on treatment outcome and patterns of failure in patients with ductal carcinoma in situ treated with breast-conserving therapy. Breast J. 2013; 19(4):365-73. DOI: 10.1111/tbj.12127. View

19.

Sweldens C, Peeters S, Van Limbergen E, Janssen H, Laenen A, Patil S . Local relapse after breast-conserving therapy for ductal carcinoma in situ: a European single-center experience and external validation of the Memorial Sloan-Kettering Cancer Center DCIS nomogram. Cancer J. 2014; 20(1):1-7. DOI: 10.1097/PPO.0000000000000025. View

20.

Ausili Cefaro G, Genovesi D, Trignani M, Di Nicola M . Human epidermal growth factor receptor-2 positivity predicts locoregional recurrence in patients with T1-T2 breast cancer. Anticancer Res. 2014; 34(3):1207-12. View