Treatment of Ipsilateral Breast Cancer Recurrence (IBCR) after Breast Conservation Therapy (BCT)

Abstract

In-breast recurrence or ipsilateral breast cancer recurrence (IBCR) suspected by imaging or palpation, second primary carcinoma and any distant metastases should be ruled out by core biopsy prior to breast surgery. The surgical standard in IBCR management is salvage mastectomy. Increasingly, however, patients express a justified desire for breast conservation in IBCR. In favourable relations of tumour and breast size, long interval between primary disease and IBCR recurrence, favourable tumour biology and ruled out distant metastases, re-BCT may be an option. As patients usually have undergone adjuvant radiotherapy already, re-radiotherapy (brachytherapy/percutaneous RT) should be explored. Systemic management must be based on tumour biology and prior treatment. While the risk of local recurrence increases following re-BCT, overall survival is not compromised.

Key words

breast cancer - ipsilateral breast recurrence - second primary breast cancer - repeat lumpectomy - salvage mastectomy

Schlüsselwörter

Brustkrebs - In-Brust-Rezidiv - Zweitkarzinom - erneute Brusterhaltung - Salvagemastektomie

Publikationsverlauf

Artikel online veröffentlicht:
18. März 2021

• References

• 1 Moossdorff M, van Roozendaal LM, Strobbe LJ. et al Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research. J Natl Cancer Inst 2014; 106 (12) dju288 . Print 2014 Dec. PMID: 25381395
• 2 Wapnir IL, Anderson SJ, Mamounas EP. et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J Clin Oncol 2006; 24: 2028-2037
• 3 Cardoso F, Costa A, Senkus E. et al. 3rd ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 3). Ann Oncol 2017; 28: 3111
• 4 Neuman HB, Schumacher JR, Francescatti AB. et al. Risk of Synchronous Distant Recurrence at Time of Locoregional Recurrence in Patients With Stage II and III Breast Cancer (AFT-01). J Clin Oncol 2018; 36: 975-980
• 5 Haffty BG, Fischer D, Beinfield M. et al. Prognosis following local recurrence in the conservatively treated breast cancer patient. Int J Radiat Oncol Biol Phys 1991; 21: 293-298
• 6 Reddy JP, Levy L, Oh JL. et al. Long-term outcomes in patients with isolated supraclavicular nodal recurrence after mastectomy and doxorubicin-based chemotherapy for breast cancer. Int J Radiat Oncol Biol Phys 2011; 80: 1453-1457
• 7 Andersson Y, de Boniface J, Jönsson PE. et al. Axillary recurrence rate 5 years after negative sentinel node biopsy for breast cancer. Br J Surg 2012; 99: 226-231
• 8 Spronk I, Schellevis FG, Burgers JS. et al. Incidence of isolated local breast cancer recurrence and contralateral breast cancer: A systematic review. Breast 2018; 39: 70-79
• 9 Walstra C, Schipper RJ, Winter-Warnars GA. et al. Local staging of ipsilateral breast tumor recurrence: mammography, ultrasound, or MRI?. Breast Cancer Res Treat 2020; 184: 385-395
• 10 Belkacemi Y, Hanna NE, Besnard C. et al. Local and Regional Breast Cancer Recurrences: Salvage Therapy Options in the New Era of Molecular Subtypes. Front Oncol 2018; 8: 112
• 11 McGuire A, Lowery AJ, Kell MR. et al. Locoregional Recurrence Following Breast Cancer Surgery in the Trastuzumab Era: A Systematic Review by Subtype. Ann Surg Oncol 2017; 24: 3124-3132
• 12 Kast K, Link T, Friedrich K. et al. Impact of breast cancer subtypes and patterns of metastasis on outcome. Breast Cancer Res Treat 2015; 150: 621-629
• 13 Metzger-Filho O, de Azambuja E, Bradbury I. et al. Analysis of regional timelines to set up a global phase III clinical trial in breast cancer: the adjuvant lapatinib and/or trastuzumab treatment optimization experience. Oncologist 2013; 18: 134-140
• 14 Fragomeni SM, Sciallis A, Jeruss JS. Molecular Subtypes and Local-Regional Control of Breast Cancer. Surg Oncol Clin N Am 2018; 27: 95-120
• 15 Voduc KD, Cheang MC, Tyldesley S. et al. Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 2010; 28: 1684-1691
• 16 Karlsson P, Cole BF, Chua BH. et al. Patterns and risk factors for locoregional failures after mastectomy for breast cancer: an International Breast Cancer Study Group report. Ann Oncol 2012; 23: 2852-2858
• 17 Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol 2018; 19: 27-39
• 18 Werutsky G, Untch M, Hanusch C. et al. Locoregional recurrence risk after neoadjuvant chemotherapy: A pooled analysis of nine prospective neoadjuvant breast cancer trials. Eur J Cancer 2020; 130: 92-101
• 19 Lee JH, Lee SK, Park SM. et al. Independent Prognostic Factors for Overall Survival after Salvage Operation for Ipsilateral Breast Tumor Recurrence Following Breast-Conserving Surgery. J Breast Cancer 2015; 18: 386-393
• 20 Winters ZE, Horsnell J, Elvers KT. et al. Systematic review of the impact of breast-conserving surgery on cancer outcomes of multiple ipsilateral breast cancers. BJS Open 2018; 2: 162-174
• 21 Halyard MY, Wasif N, Harris EE. et al. ACR Appropriateness Criteria(R) local-regional recurrence (LR) and salvage surgery: breast cancer. Am J Clin Oncol 2012; 35: 178-182
• 22 AGO. Diagnostic and treatment of early and metastatic breast cancer. 2020 http://www.ago-online.org
• 23 DGS. Deutsche Gesellschaft für Senologie: Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. 2017
• 24 NCCN. National Comprehensive Cancer Network: Practice Guidelines in Oncology: Breast Cancer. 2020 http://www.nccn.org
• 25 Yoon CI, Ahn SG, Kim D. et al. Repeat Sentinel Lymph Node Biopsy for Ipsilateral Breast Tumor Recurrence After Breast Conserving Surgery With Sentinel Lymph Node Biopsy: Pooled Analysis Using Data From a Systematic Review and Two Institutions. Front Oncol 2020; 10: 518568
• 26 McGinity AC, Lautner MA, Jatoi I. Management of the clinically node-negative axilla in primary and locally recurrent breast cancer. Surg Oncol Clin N Am 2014; 23: 463-471
• 27 Wapnir IL, Price KN, Anderson SJ. et al. Efficacy of Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional Recurrence of Breast Cancer: Final Analysis of the CALOR Trial. J Clin Oncol 2018; 36: 1073-1079
• 28 Duncan MA, Lautner MA. Sarcomas of the Breast. Surg Clin North Am 2018; 98: 869-876
• 29 Dogan A, Kern P, Schultheis B. et al. Radiogenic angiosarcoma of the breast: case report and systematic review of the literature. BMC Cancer 2018; 18: 463
• 30 Elfgen C, Güth U, Gruber G. et al. Breast-conserving surgery with intraoperative radiotherapy in recurrent breast cancer: the patient’s perspective. Breast Cancer 2020; 27: 1107-1113
• 31 Alpert TE, Kuerer HM, Arthur DW. et al. Ipsilateral breast tumor recurrence after breast conservation therapy: outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation. Int J Radiat Oncol Biol Phys 2005; 63: 845-851
• 32 Yoshida A, Takahashi O, Okumura Y. et al. Prognosis after mastectomy versus repeat lumpectomy in patients with ipsilateral breast cancer recurrence: A propensity score analysis. Eur J Surg Oncol 2016; 42: 474-480
• 33 Wu Y, Shi X, Li J. et al. Prognosis of Surgical Treatment After Ipsilateral Breast Tumor Recurrence. J Surg Res 2020; 258: 23-37
• 34 Baek SY, Kim J, Chung IY. et al. Long-term survival outcomes of repeat lumpectomy for ipsilateral breast tumor recurrence: a propensity score-matched analysis. Breast Cancer Res Treat 2020; 185: 155-164
• 35 Su Y, Guo R, Xue J. et al. Increased Mortality with Repeat Lumpectomy Alone After Ipsilateral Breast Tumor Recurrence. Oncologist 2019; 24: e818-e827
• 36 Leonardi MC, Tomio L, Radice D. et al. Local Failure After Accelerated Partial Breast Irradiation with Intraoperative Radiotherapy with Electrons: An Insight into Management and Outcome from an Italian Multicentric Study. Ann Surg Oncol 2020; 27: 752-762
• 37 Veronesi U, Boyle P, Goldhirsch A. et al. Breast cancer. Lancet 2005; 365: 1727-1741