Local recurrence of breast cancer following surgery and radiotherapy: incidence and outcome.

Abstract ABSTRACT: Local recurrence of cancer in the treated breast following breast-conserving surgery and radiotherapy occurs in a minority of patients, but can represent a significant clinical problem. The impact of local relapse on the subsequent course of the disease is disputed. The aim of this retrospective review was to identify the rate and prognostic factors for breast recurrence and to determine the subsequent outcome. The case notes of 2159 patients treated between 1989 and 1992 were reviewed. Actuarial local relapse rate was 6.3% at 5 years. Factors predictive for recurrence on multivariate analysis were age ( P P =0.019), and pathological UICC stage ( P =0.01). One hundred and sixty-one patients developed local recurrence in the treated breast of whom 101 were treated with further surgery. The 5-year cancer-specific survival of this group was comparable with that of the patients who remained free of breast relapse (82 vs. 88%) but subsequently fell to 61 vs. 80% at 8 years ( P P =0.008). Systemic therapy should be considered for patients with early breast recurrence in view of their inferior survival. Copyright 2002 The Royal College of Radiologists. Published by Elsevier Science Ltd. All rights reserved.