Risk Factors for Ipsilateral Breast Tumor Recurrence in Triple-Negative or HER2-Positive Breast Cancer Patients Who Achieve a Pathologic Complete Response After Neoadjuvant Chemotherapy

2020 ◽  
Author(s):  
Makoto Ishitobi ◽  
Naoko Matsuda ◽  
Mizuho Tazo ◽  
Sayuka Nakayama ◽  
Ryu Tokui ◽  
...  
Keyword(s):  
Breast Tumor ◽  
Tumor Recurrence ◽  
Triple Negative ◽  
Pathologic Complete Response ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Complete Response ◽  
Breast Cancer Patients ◽  
Ipsilateral Breast ◽  
Her2 Positive ◽  
Positive Breast Cancer

Risk factors of ipsilateral breast tumor recurrence in triple-negative or HER2-positive breast cancer patients who achieved pathological complete response after neoadjuvant chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12599-e12599
Author(s):  
Mizuho Tazo ◽  
Yasuyuki Kojima ◽  
Atsushi Yoshida ◽  
Sayuka Nakayama ◽  
Ryu Tokui ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Tumor ◽  
Tumor Recurrence ◽  
Triple Negative ◽  
Breast Surgery ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Complete Response ◽  
Ipsilateral Breast ◽  
Her2 Positive ◽  
Breast Recurrence

e12599 Background: To date, patients undergo breast surgery after neoadjvant chemotherapy (NAC) even though they achieve clinical complete response (cCR). The safety of omitting breast surgery for the patients who are predicted to be pCR has recently investigated in some research, however we still have not reached to a definite consensus yet. We may consider the breast surgery omission on the assumption that the rate of ipsilateral breast tumor recurrence (IBTR)after achieving pCR is acceptably low. The purpose of this study is to examine the rate of and evaluate the clinical features of IBTR in patients achieving pCR after NAC. Methods: In this study, a total of 278 patients with HER2-positive or Triple negative type primary breast cancer were enrolled from4 institutions. They were all diagnosed as ypT0 after breast conserving surgery and received postoperative radiotherapy. Occurrence of IBTR and other clinicopathological factors were collected by retrospective chart review. Results: Of the 278 patients, 49 patients (18%) were ER+/HER2+, 106 patients (38%) were ER-/HER2+ and 123 patients (44%) were ER-/HER2-. We found breast recurrence in 11 patients (4%) as a first recurrence. The 5-year breast recurrence rate was 4.5% in total, 2.2% in ER+/HER2+, 4.0% in ER-/HER2+ and 4.6% in ER-/HER2-, respectively. There was no significantly difference among subtypes. Interestingly, the 5-year breast recurrence rate of patients under 40-year-old was 12.3% which was significantly higher than patients with and above 40-year-old (3.1%, p=0.002). Conclusions: We should be extremely careful when consider omitting breast surgery for patients younger than 40 even if they achieved pCR after NAC.

Outcome after Mastectomy for Ipsilateral Breast Tumor Recurrence after Breast Conserving Surgery

2010 ◽  
Vol 76 (8) ◽  
pp. 829-834 ◽  
Author(s):  
H. Randall Beard ◽  
Emily F. Cantrell ◽  
Gregory B. Russell ◽  
Marissa Howard-Mcnatt ◽  
Perry Shen ◽  
...  
Keyword(s):  
Breast Tumor ◽  
Tumor Recurrence ◽  
Ductal Carcinoma ◽  
Ipsilateral Breast Tumor Recurrence ◽  
Breast Conserving Surgery ◽  
Breast Cancer Patients ◽  
Ipsilateral Breast ◽  
Increased Risk ◽  
Group A

Ipsilateral breast tumor recurrence (IBTR) is a risk after breast conserving surgery, and is traditionally treated with mastectomy. Given the limited literature on outcome after mastectomy for IBTR, we evaluated our long-term data for this group. A retrospective review was conducted using a database of 2101 breast cancer patients at a single institution. Fifty-nine patients underwent breast conserving surgery and experienced an IBTR. Exclusion criteria included repeat lumpectomy or metastatic disease before mastectomy. Patients presented with invasive ductal (58%), invasive lobular (7%), other invasive (11%), or ductal carcinoma in situ (24%). Initial tumors were Tis (24%), T1 (42%), T2 (20%), T3 (2%), or not recorded (12%). IBTR lesions were Tis (20%), T1 (46%), T2 (25%), or T3 (9%). Median follow-up after mastectomy was 4.6 years. Thirteen patients (22%) had post-mastectomy recurrence (PMR), which decreased overall survival ( P = 0.002). PMR was more common with larger IBTR tumors ( P = 0.03), specifically IBTR ≥ T2 ( P = 0.003). Eighty-five per cent of PMR occurred within 2 years of mastectomy. Mastectomy for IBTR remains effective treatment for most patients, but the risk of PMR remains. Patients with IBTR tumors >2 cm have an increased risk of PMR. Strict follow-up should be routine, especially during the first 24 months.

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