Second invasive breast cancers in patients treated with breast-conserving therapy.

Abstract

OBJECTIVE:

Second breast cancers after breast-conserving therapy (BCT) include ipsilateral breast tumor recurrence (IBTR) and metachronous contralateral breast cancer (CBC). Each IBTR is further classified as true recurrence (TR) or new primary tumor (NP). We aim to compare survival outcomes of TR, NP and CBC, and explore the optimal treatments.

METHODS:

168,427 patients with primary breast cancer who underwent BCT between 1990 and 2005 were identified in the SEER database. The risks of IBTR and CBC were estimated by annual hazard rate. The breast cancer-specific survival (BCSS) were assessed using multivariable Cox regression analysis.

RESULTS:

With median follow-up of 13 years after BCT, 5413 patients developed an IBTR and 4050 patients had a CBC. The risk of IBTR peaked between 10 and 15 years after BCT, while the risk of CBC distributed evenly. 45.9% of IBTRs were classified as a TR and 54.1% as an NP. The time interval from primary breast cancer to NP was longer than to TR and CBC (P < 0.001). Patients with TR had a poorer BCSS than NP (P = 0.003) and CBC (P = 0.002). There was no difference in BCSS between mastectomy and repeat BCT for treating TR (P = 0.584) or NP (P = 0.243). The BCSS of CBCs treated with BCT was better than mastectomy (P = 0.010). Chemotherapy didn't improve the survival of patients with TR (P = 0.058). However, TRs with grade III or negative hormone receptors benefited from chemotherapy significantly.

CONCLUSION:

Patients with TR had a poorer BCSS than NP and CBC. Classifying IBTR may provide clinical significance for treatments.

• Authors: Jin Wang, Hailin Tang, Kanhua Yin, Xing Li, Xiaoming Xie, Kevin S Hughes
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 47 Issue 10 Pg. 2492-2498 (10 2021) ISSN: 1532-2157 [Electronic] England
• PMID: 34134902 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Chemical References

• Antineoplastic Agents
• Receptors, Estrogen
• Receptors, Progesterone

Topics

• Aged
• Antineoplastic Agents (therapeutic use)
• Breast Neoplasms (epidemiology, mortality, pathology, therapy)
• Chemotherapy, Adjuvant
• Female
• Follow-Up Studies
• Humans
• Lymphatic Metastasis
• Mastectomy, Segmental
• Middle Aged
• Neoplasm Grading
• Neoplasm Recurrence, Local (epidemiology, mortality, pathology, therapy)
• Neoplasms, Second Primary (epidemiology, mortality, pathology, therapy)
• Proportional Hazards Models
• Receptors, Estrogen (metabolism)
• Receptors, Progesterone (metabolism)
• Retrospective Studies
• SEER Program
• Salvage Therapy
• Survival Rate
• Time Factors
• Tumor Burden
• United States (epidemiology)