J Breast Cancer.  2015 Sep;18(3):279-284. 10.4048/jbc.2015.18.3.279.

Prognostic Factors for Distant Metastasis in Patients with Locoregional Recurrence after Mastectomy

• Jeong Y
• Kim SS
• Gong G
• Lee HJ
• Ahn SH
• Son BH
• Lee JW
• Choi EK
• Lee SW
• Ahn SD

• KMID: 2407576
• DOI: http://doi.org/10.4048/jbc.2015.18.3.279

Abstract

PURPOSE
The purpose of this study was to identify patients with high risk of distant metastasis (DM) after salvage treatment for postmastectomy locoregional recurrence (LRR).
METHODS
We retrospectively reviewed 142 patients who received salvage radiotherapy with or without wide excision for isolated LRR after mastectomy between January 1999 and December 2012. Distant metastasis-free survival (DMFS) was estimated from the date of diagnosis of isolated LRR to the date of DM or last follow-up using the Kaplan-Meier method, and Cox regression analysis was performed to identify prognostic factors for DM.
RESULTS
The median follow-up period was 54 months. The major failure pattern was DM (56%) and the 5-year DMFS was 43%. In multivariate analysis, initial N (iN) stage, recurrent N (rN) stage, and hormone receptor (HR) status were significant prognostic factors for DM (5-year DMFS: iN0 vs. iN1-3, 73% vs. 25%, p<0.001; rN0 vs. rN1-3, 61% vs. 29%, p<0.001; HR+ vs. HR-, 49% vs. 21%, p<0.001).
CONCLUSION
Patients with lymph node involvement and/or HR- specimens seem to experience more DM than patients with chest wall-only recurrence and HR+ specimens. Further studies are needed to investigate the role of chemotherapy in these patients.

Keyword

Breast neoplasms; Drug therapy; Local neoplasm recurrence; Mastectomy; Neoplasm metastasis

MeSH Terms

Breast Neoplasms
Diagnosis
Drug Therapy
Follow-Up Studies
Humans
Lymph Nodes
Mastectomy*
Multivariate Analysis
Neoplasm Metastasis*
Neoplasm Recurrence, Local
Radiotherapy
Recurrence*
Retrospective Studies
Thorax

Figure

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  Figure 1 Overall survival (OS) (A) and distant metastasis-free survival (DMFS) (B) rates in the entire patients.

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  Figure 2 Distant metastasis-free survival (DMFS) rates depending on the (A) initial N (iN) stage, (B) recurrent N (rN) stage, and (C) hormone receptor status.

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  Figure 3 Distant metastasis-free survival (DMFS) rates depending on the (A) hormone receptor (HR) status and initial N (iN) stage, (B) hormone receptor status and recurrent N (rN) stage.

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