유방 전 절제술 후 발생한 국소 또는 구역 재발 환자의 임상적 특징 및 예후

Abstract

Purpose: Despite the increasing use of breast-conserving therapy, modified radical mastectomy retains an important primary treatment of breast cancer. The aim of this study was to evaluate the survival of patients with isolated locoregional recurrence (LR) and the prognostic factors for LR after mastectomy. Methods: We retrospectively analyzed 76 patients who were treated for LR after mastectomy at our hospital between 1987 and 2002. These patients had only isolated LR. The following parameters were analyzed: primary tumor size, primary nodal status, stage, estrogen receptor status, treatment modalities for LR, disease free interval from primary operation and re-recurrence interval. Results: The median time to develop LR was 18.4 months and the median follow-up period from LR was 19.3 months (range 1.3∼113 months). The 2-year overall survival rate from LR showed 46% and 5-year overall survival rate was 15%. Out of 76 patients, 47 patients (61.8%) developed re-recurrence and the median duration to re-recurrence was 9.6 months. The pattern of re-recurrence showed 45 patients with systemic recurrence and 2 patients with LR. The initial node status (P=0.041), the estrogen receptor status (P=0.009) and re-recurrence interval from LR (P=0.017) were statistically significant factors for survival. The primary tumor size, the stage, the disease free interval, and the treatment modalities for LR were not statistically significant. Conclusion: The re-recurrence rate after isolated LR in patients with breast cancer showed 61.8% and these patients almost always had systemic recurrence. This study could not show the difference of survival according to the treatment modality for LR but the systemic treatment should be considered for the patients with unfavorable prognostic factors.