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April 1991

Local-Regional Breast Cancer Recurrence Following Mastectomy

Author Affiliations

Participating Investigators
From the Departments of Surgery (Drs Crowe, Gordon, Shenk, Hubay, and Shuck) and Epidemiology and Biostatistics (Dr Gordon), Ireland Cancer Center (Dr Gordon), and Department of Radiation Therapy (Dr Antunez), Case Western Reserve University and University Hospitals of Cleveland, Ohio.

Arch Surg. 1991;126(4):429-432. doi:10.1001/archsurg.1991.01410280027002

• 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.

(Arch Surg. 1991;126:429-432)