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- Title
Thoracic Wall Recurrences after Mastectomy: Our Instutional Long Term Results.
- Authors
Karataş, İrem; Ercan, Leman Damla; Emiroğlu, Selman; Tükenmez, Mustafa; Özmen, Vahit; Müslümanoğlu, Mahmut; İğci, Abdullah; Küçücük, Seden; Aydiner, Adnan; Cabioğlu, Neslihan
- Abstract
Objective: Thoracic wall recurrences following mastectomy are seen relatively rare in breast cancer. Local and regional recurrences are seen about %5-10 in breast cancer. Of those, 20% to 30% of recurrences are seen with regional recurrences. The aim of this study is to investigate the clinical, pathological features and long-term survival of patients with local recurrence after mastectomy. Materials and Methods: Between 1993 and 2015, 27 patients who were operated with a diagnosis of breast cancer at the Istanbul Medical Faculty Breast Surgery Clinic, developed recurrence in the thorax wall. Clinicopathologic and long-term survival data was obtained for 27 patients. Results: Median age was 47 (25-79) and 63% of patients (n=17) were premenopausal. The majority of patients were found to have stage III disease (30%), whereas 30% had stage 1, and %26 had stage 2 disease. Furthermore, the majority of patients were found to have invasive ductal carcinoma as histological tumor type. Hormone receptor positivity (estrogen and/or progesterone receptor positivity) was detected in 16 patients (67%, n=24), whereas 2 patients were found to have HER-2 positivity (15%, n=13). One patient (6.7%, n=15) with hormone receptor positivity upfront was turned to be hormone receptor negative (ER/PR negative) in recurrence. At a median follow-up of 87 month (12-261), 21 patients (78%) had isolated thoracic wall recurrence, whereas 6 patients (22%) had synchronous thoracic®ional recurrence. The median recurrence time was 44 months (6-260), and 37% (n=10) of recurrences were detected in the first 2 years, whereas 22% of them (n=6) were seen between 2 and 5 years, and 41% (n=11) of them developed after 5 years. Twenty patients (74%) underwent a surgical procedure as recurrent mass excision+/- axillary dissection, and 7 patients (26%) underwent systemic treatment after tissue biopsy (core / FNAB). Hormone-positive patients (median recurrence month=89.5) were less likely to be found a recurrence compared to the hormone receptor-negative patients (median recurrence month, 89.5 vs 14.5; p=0.002). Four patients (15%) developed distant metastasis after recurrence. There were 3 deaths due to breast cancer during the follow-up period and the overall 10-year survival rate was 86.8%. Conclusion: Our findings suggest that the majority of patients who developed local/regional relapse after mastectomy relapsed within the first five years, and HR-positive patients were less likely to recur than HR-negative patients. Therefore, triple negative patients may require more aggressive local and systemic therapies.
- Subjects
BREAST cancer surgery; BREAST cancer diagnosis; MASTECTOMY complications; CANCER relapse; BREAST biopsy
- Publication
European Journal of Breast Health, 2019, Vol 15, pS10
- ISSN
2587-0831
- Publication type
Article