Local-regional breast cancer recurrence following mastectomy
J. P. Crowe Jr, N. H. Gordon, A. R. Antunez, R. R. Shenk, C. A. Hubay and J. M. Shuck
Department of Surgery, Case Western Reserve University, Cleveland, OH.
Local-regional recurrence patterns were investigated in 1392 patients with
breast cancer. Primary treatment for all patients included a mastectomy.
Nine hundred seventeen patients had negative nodes and did not receive
systemic therapy. Four hundred seventy-five patients had node metastases
and were randomized to receive different combinations of chemoendocrine
therapy. Follow-up ranged between 5 and 16 years. Two hundred thirty
(25.8%) node-negative patients have had recurrences, with the initial
recurrence being local-regional in 9.2%. Two hundred forty-two (50.9%)
node-positive patients have had recurrences, with the initial recurrence
being local-regional in 17.1%. Larger tumors and more extensive node
involvement were associated with more first local-regional recurrences. The
relative percent of first local-regional recurrence among patients in whom
cancer recurred was similar for node-negative and node-positive patients
(35.4% and 33.5%, respectively). In 63.6% of patients in whom cancer
recurred, first local-regional recurrence were distant. Larger tumors, more
extensive node involvement, and a shorter disease-free interval after
mastectomy were associated with more rapid appearance of distant recurrence
among these patients.
