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Published in: World Journal of Surgical Oncology 1/2016

Open Access 01-12-2016 | Research

Comparison of ipsilateral breast tumor recurrence after breast-conserving surgery between ductal carcinoma in situ and invasive breast cancer

Authors: Young Jin Choi, Young Duck Shin, Young Jin Song

Published in: World Journal of Surgical Oncology | Issue 1/2016

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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.
Literature
1.
go back to reference Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.CrossRefPubMed Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.CrossRefPubMed
2.
go back to reference Karasawa K, Mitsumori M, Yamauchi C, Gomi K, Kataoka M, Uematsu T, et al. 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;12:91–8.CrossRefPubMed Karasawa K, Mitsumori M, Yamauchi C, Gomi K, Kataoka M, Uematsu T, et al. 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;12:91–8.CrossRefPubMed
3.
go back to reference Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat. 2012;133:831–41.CrossRefPubMed Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat. 2012;133:831–41.CrossRefPubMed
4.
go back to reference Kim HJ, Han W, Yi OV, Shin HC, Ahn SK, Koh BS, et al. 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;130:499–505.CrossRefPubMed Kim HJ, Han W, Yi OV, Shin HC, Ahn SK, Koh BS, et al. 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;130:499–505.CrossRefPubMed
5.
go back to reference Cefaro GA, 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;34:1207–12.PubMed Cefaro GA, 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;34:1207–12.PubMed
6.
go back to reference Jobsen J, van der Palen J, Riemersma S, Heijmans H, Ong F, Struikmans H. Pattern of ipsilateral breast tumor recurrence after breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2014;89:1006–14.CrossRefPubMed Jobsen J, van der Palen J, Riemersma S, Heijmans H, Ong F, Struikmans H. Pattern of ipsilateral breast tumor recurrence after breast-conserving therapy. Int J Radiat Oncol Biol Phys. 2014;89:1006–14.CrossRefPubMed
7.
go back to reference Mechera R, Viehl CT, Oertli D. Factors predicting in-breast tumor recurrence after breast-conserving surgery. Breast Cancer Res Treat. 2009;116:171–7.CrossRefPubMed Mechera R, Viehl CT, Oertli D. Factors predicting in-breast tumor recurrence after breast-conserving surgery. Breast Cancer Res Treat. 2009;116:171–7.CrossRefPubMed
8.
go back to reference Sweldens C, Peeters S, van Limbergen E, Janssen H, Laenen A, Patil S, et al. 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;20:1–7.CrossRefPubMed Sweldens C, Peeters S, van Limbergen E, Janssen H, Laenen A, Patil S, et al. 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;20:1–7.CrossRefPubMed
9.
go back to reference Kim H, Noh JM, Choi DH, Lee J, Nam SJ, Lee JE, et al. Excision alone for small size ductal carcinoma in situ of the breast. Breast. 2014;23:586–90.CrossRefPubMed Kim H, Noh JM, Choi DH, Lee J, Nam SJ, Lee JE, et al. Excision alone for small size ductal carcinoma in situ of the breast. Breast. 2014;23:586–90.CrossRefPubMed
10.
go back to reference Vicini FA, Shaitelman S, Wilkinson JB, Shah C, Ye H, Kestin LL, et al. 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;19:365–73.CrossRefPubMed Vicini FA, Shaitelman S, Wilkinson JB, Shah C, Ye H, Kestin LL, et al. 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;19:365–73.CrossRefPubMed
11.
go back to reference Wang SY, Chu H, Shamliyan T, Jalal H, Kuntz KM, Kane RL, et al. Network meta-analysis of margin threshold for women with ductal carcinoma in situ. J Natl Cancer Inst. 2012;104:507–16.CrossRefPubMedPubMedCentral Wang SY, Chu H, Shamliyan T, Jalal H, Kuntz KM, Kane RL, et al. Network meta-analysis of margin threshold for women with ductal carcinoma in situ. J Natl Cancer Inst. 2012;104:507–16.CrossRefPubMedPubMedCentral
12.
go back to reference Buchholz TA, Somerfield MR, Griggs JJ, El-Eid S, Hammond ME, Lyman GH, et al. Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol. 2014;32:1502–6.CrossRefPubMed Buchholz TA, Somerfield MR, Griggs JJ, El-Eid S, Hammond ME, Lyman GH, et al. Margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive breast cancer: American Society of Clinical Oncology endorsement of the Society of Surgical Oncology/American Society for Radiation Oncology consensus guideline. J Clin Oncol. 2014;32:1502–6.CrossRefPubMed
13.
go back to reference 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;30:11–6.CrossRefPubMed 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;30:11–6.CrossRefPubMed
14.
go back to reference Haffty BG, 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;14:52–7.PubMed Haffty BG, 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;14:52–7.PubMed
15.
go back to reference Yau TK, Soong IS, Chan K, Chan M, Cheung P, Lau HW, et al. 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;68:667–72.CrossRefPubMed Yau TK, Soong IS, Chan K, Chan M, Cheung P, Lau HW, et al. 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;68:667–72.CrossRefPubMed
16.
go back to reference Panet-Raymond V, Truong PT, Alexander C, Lesperance M, McDonald RE, Watson PH. Clinicopathologic factors of the recurrent tumor predict outcome in patients with ipsilateral breast tumor recurrence. Cancer. 2011;117:2035–43.CrossRefPubMed Panet-Raymond V, Truong PT, Alexander C, Lesperance M, McDonald RE, Watson PH. Clinicopathologic factors of the recurrent tumor predict outcome in patients with ipsilateral breast tumor recurrence. Cancer. 2011;117:2035–43.CrossRefPubMed
17.
go back to reference Anderson SJ, Wapnir I, Dignam JJ, Fisher B, Mamounas EP, Jeong JH, et al. 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;27:2466–73.CrossRefPubMedPubMedCentral Anderson SJ, Wapnir I, Dignam JJ, Fisher B, Mamounas EP, Jeong JH, et al. 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;27:2466–73.CrossRefPubMedPubMedCentral
18.
go back to reference Ishitobi M, Okumura Y, Arima N, Yoshida A, Nakatsukasa K, Iwase T, et al. Breast cancer subtype and distant recurrence after ipsilateral breast tumor recurrence. Ann Surg Oncol. 2013;20:1886–92.CrossRefPubMed Ishitobi M, Okumura Y, Arima N, Yoshida A, Nakatsukasa K, Iwase T, et al. Breast cancer subtype and distant recurrence after ipsilateral breast tumor recurrence. Ann Surg Oncol. 2013;20:1886–92.CrossRefPubMed
19.
go back to reference Fisher ER, 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;91:1679–87.CrossRefPubMed Fisher ER, 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;91:1679–87.CrossRefPubMed
20.
go back to reference Tamura N, Tsuda H, Yoshida M, Hojo T, Akashi-Tanaka S, Kinoshita T, et al. Clinicopathological predictive factors for ipsilateral and contralateral events following initial surgery to treat ductal carcinoma in situ. Breast Cancer. 2016;23:510-8. Tamura N, Tsuda H, Yoshida M, Hojo T, Akashi-Tanaka S, Kinoshita T, et al. Clinicopathological predictive factors for ipsilateral and contralateral events following initial surgery to treat ductal carcinoma in situ. Breast Cancer. 2016;23:510-8.
21.
go back to reference Demicheli R, Ardoino I, Boracchi P, Coradini D, Agresti R, Ferraris C, et al. 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.CrossRefPubMedPubMedCentral Demicheli R, Ardoino I, Boracchi P, Coradini D, Agresti R, Ferraris C, et al. 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.CrossRefPubMedPubMedCentral
22.
go back to reference Fisher B, Wickerham DL, Deutsch M, Anderson S, Redmond C, Fisher ER. Breast tumor recurrence following lumpectomy with and without breast irradiation: an overview of recent NSABP findings. Semin Surg Oncol. 1992;8:153–60.PubMed Fisher B, Wickerham DL, Deutsch M, Anderson S, Redmond C, Fisher ER. Breast tumor recurrence following lumpectomy with and without breast irradiation: an overview of recent NSABP findings. Semin Surg Oncol. 1992;8:153–60.PubMed
23.
go back to reference Silverstein MJ, Lagios MD, Groshen S, Waisman JR, Lewinsky BS, Martino S, et al. The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med. 1999;340:1455–61.CrossRefPubMed Silverstein MJ, Lagios MD, Groshen S, Waisman JR, Lewinsky BS, Martino S, et al. The influence of margin width on local control of ductal carcinoma in situ of the breast. N Engl J Med. 1999;340:1455–61.CrossRefPubMed
24.
go back to reference Rudloff U, Brogi E, Reiner AS, Goldberg JI, Brockway JP, Wynveen CA, et al. 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;251:583–91.CrossRefPubMed Rudloff U, Brogi E, Reiner AS, Goldberg JI, Brockway JP, Wynveen CA, et al. 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;251:583–91.CrossRefPubMed
25.
go back to reference McCormick B, Winter K, Hudis C, Kuerer HM, Rakovitch E, Smith BL, et al. RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation. J Clin Oncol. 2015;33:709–15.CrossRefPubMedPubMedCentral McCormick B, Winter K, Hudis C, Kuerer HM, Rakovitch E, Smith BL, et al. RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation. J Clin Oncol. 2015;33:709–15.CrossRefPubMedPubMedCentral
Metadata
Title
Comparison of ipsilateral breast tumor recurrence after breast-conserving surgery between ductal carcinoma in situ and invasive breast cancer
Authors
Young Jin Choi
Young Duck Shin
Young Jin Song
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-016-0885-6

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