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KMID : 1134120200230030279
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Journal of Breast Cancer
2020 Volume.23 No. 3 p.279 ~ p.290
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Identifying Long-Term Survival Candidates among Patients with Isolated Locoregionally Recurrent Breast Cancer: Implications of the Use of Systemic Chemotherapy
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Kim Byoung-Hyuck
Shin Kyung-Hwan
Chie Eui-Kyu
Kim Jin-Ho
Kim Kyu-Bo
Hwang Ki-Tae
Kim Jong-Jin
Choi In-Sil
Park Jin-Hyun
Kim Su-Zy
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Abstract
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Purpose: We aimed to investigate the clinicopathologic factors associated with distant metastasis (DM) and post-recurrence overall survival (OS) after salvage treatments for isolated locoregional recurrence (ILRR) of breast cancer and identify long-term surviving patients for providing a more personalized therapy.
Methods: We analyzed 125 patients who underwent salvage local treatments for ILRR after initial curative breast surgery.
Results: Fifty-two (41.6%) patients experienced secondary recurrence or disease progression, of which 20 (38.5%) experienced a secondary locoregional recurrence and 40 (76.9%) experienced DM as the first site of failure. In multivariate analysis of distant metastasis free survival (DMFS) and post-recurrence OS, the initial pN2-3 stage, a disease-free interval of < 36 months, and non-curative resection for recurrent disease were independently poor prognosticators. The score for patients stratified according to the number of risk factors increased from 0 to 3; the corresponding 5-year DMFS rates were 91.4%, 53.0%, 35.9%, and 0% and the 5-year OS rates were 97.3%, 70.4%, 32.7%, and 25.0%, respectively (p < 0.001). Systemic chemotherapy reduced DM in patients with a score of 2?3, but it did not in those with a score of 0-1.
Conclusion: Our collective stratification can help with prognosis prediction for ILRR of breast cancer. Depending on the DM risk of patients, the potential combination of systemic therapy should be discussed further.
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KEYWORD
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Breast neoplasm, Neoplasm recurrence, Local, Risk factors, Survivors
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