J Breast Cancer.  2020 Dec;23(6):622-634. 10.4048/jbc.2020.23.e66.

Survival and Prognostic Factors for Breast Cancer Patients with Regional Oligo-Recurrence

• Baek JY
• Choi DH
• Park W
• Kim H
• Cho WK
• Yoo GS

• KMID: 2511846
• DOI: http://doi.org/10.4048/jbc.2020.23.e66

Abstract

urpose: This study aimed to evaluate survival outcomes and identify prognostic factors for regional oligo-recurrence in breast cancer patients who received salvage local treatment.
Methods
In the breast cancer registry of our institution, 18,790 patients received curative surgery for stage I–III breast cancer between January 1995 and June 2016. Of those patients, only 87 (0.5%)underwent salvage local treatment for isolated nodal recurrence on the axillary lymph nodes (ALNs) (n = 58), supraclavicular lymph nodes (SCNs) (n = 17), or internal mammary lymph nodes (IMNs) (n = 12).
Results
The median follow-up duration after regional oligo-recurrence was 49 months (range: 6–194 months). For patients with recurrence of ALN, SCN, or IMN, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 40.0%, 32.1%, and 25.0%, respectively (p = 0.3) and 62.7%, 70.0%, and 58.3%, respectively(p = 0.97). In the multivariable analysis for PFS, age at recurrence ≥ 65 years, disease-free interval < 24 months, non-luminal A subtype, and in-field failure (marginally significant) were found to be risk factors (RFs). However, the location of the tumor was not a significant factor for PFS (p = 0.71). When we stratified patients by the number of RFs, the 5-year PFS rates were 67.5% for patients with ≤ 1 RF and 7.3% for those with > 1 RF (p < 0.01). For patients with ≤ 1 RF, the 5-year PFS rates were 73.5% in the ALN group and 51.1% in the SCN/IMN group (p = 0.09). For patients with > 1 RF, the 5-year PFS rates were 7.3% in the ALN group and 7.1% in the SCN/IMN group (p = 1.00).
Conclusion
In breast cancer patients with regional oligo-recurrence, clinical outcomes after salvage treatment were favorable in patients with ≤ 1 RF, while patients with > 1 RF had poor prognoses irrespective of the location of recurrence.

Keyword

Breast neoplasms; Local therapy; Lymph nodes; Prognosis; Recurrence