According to a recent article published in the European Journal of Surgical Oncology, women initially diagnosed with early breast cancer who experience a local cancer recurrence after 5 years of treatment have a significantly improved prognosis over those who experience a local recurrence within 5 years of treatment. In addition, women who undergo a mastectomy for their recurrence have significantly improved survival compared to those who undergo local surgery for their recurrence.
Breast cancer is diagnosed in approximately 250,000 women annually in the U.S. alone. Early breast cancer (cancer that has not spread from the breast and some underarm [axillary] lymph nodes) is often treated with breast-conserving therapy (BCT); outcomes with BCT are similar to those of treatment with a mastectomy.
BCT includes the surgical removal of the cancer along with a margin of healthy tissue; axillary lymph nodes are also tested or removed. Following surgery, women undergo radiation therapy, chemotherapy, and/or hormone therapy to reduce the risk of recurrences over surgery alone. A mastectomy, on the other hand, is the removal of the entire breast.
With more women being diagnosed with earlier breast cancer, researchers continue to gather information regarding their outcomes. These findings should provide a greater understanding of long-term outcomes for these patients.
Researchers from The Netherlands recently evaluated data from 3,280 women who had been diagnosed with early breast cancer between 1982 and 1997. All women had undergone BCT.
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- Among women who experienced a local cancer recurrence (recurrence at or near the site of origin), distant, recurrence-free survival (no recurrences at distant sites from the breast) was 68% for women whose local recurrence occurred after 5 years of treatment and 41% for women whose local recurrence occurred within 5 years of treatment.
- Local excision (removal of the cancer and surrounding tissue) of the recurrence resulted in 50% of the women experiencing a subsequent local recurrence, while a mastectomy following the initial recurrence resulted in only an 11% incidence of a subsequent local recurrence.
The researchers concluded that women diagnosed with early breast cancer who experience a local recurrence within 5 years of BCT have a significantly higher risk of developing a recurrence than those who experience a local recurrence 5 years after receiving BCT. Furthermore, those treated with a mastectomy for their local recurrence have a significantly reduced risk of developing a subsequent local recurrence than those treated with local excision.
Women initially diagnosed with early breast cancer who experience a cancer recurrence within 5 years of BCT should discuss all therapeutic options with their physician to minimize their risk of a subsequent recurrence.
Reference: van der Sangen M, van de Poll-Franse L, Roumen R, et al. The Prognosis of Patients with Local Recurrence More Than Five Years After Breast Conservation Therapy for Invasive Breast Carcinoma. European Journal of Surgical Oncology. 2006; 32: 34-38.
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