Journal Basic Info
- Impact Factor: 1.995**
- H-Index: 8
- ISSN: 2474-1647
- DOI: 10.25107/2474-1647
- Gynecological Surgery
- Thoracic Surgery
- Otolaryngology - Head and Neck Surgery
- Surgical Oncology
- Cardiovascular Surgery
- Oral and Maxillofacial Surgery
- Vascular Surgery
Citation: Clin Surg. 2019;4(1):2382.Research Article | Open Access
Factors Predicting Locoregional Recurrence after Wide Local Excision � Experience from a Tertiary Centre
Department of General Surgery, Tan Tock Seng Hospital, Singapore
Department of Pathology, Tan Tock Seng Hospital, Singapore
Department of Radiation Oncology, National University Cancer Institute Singapore, Singapore
Introduction: Locoregional Recurrence (LR) can still develop after breast conserving surgery despite adequate surgical margins and whole breast radiation, even with a boost to the tumour bed. In this study, we evaluated predictors of LR and examined its effect on survival.
Methods: Retrospective review was performed of 713 women diagnosed with breast cancer from 2004 to 2011.
Results: Locoregional recurrence developed in 74 women (10.4%) and occurred adjacent to the previous tumour bed in half the instances. Surgical margins (P<0.001), nodal involvement (P=0.002), radiation (P=0.003) and 5 years of hormonal therapy (P<0.001) were independent predictors of LR. While LR had no effect on overall survival in women with DCIS (P=0.756), it was associated with poorer distant recurrence-free and overall survival in women with invasive cancer (P<0.001, HR 114.200, 95% CI 40.630–320.900 and P<0.001, HR 14.210, 95% CI 5.651–35.720 respectively). Radiation and hormonal therapy improved survival, showing an additive effect. Radiation, without hormonal therapy, did not improve recurrence-free survival, both locoregional (P=0.190) and distant (P=0.189), nor overall survival (P=0.236) in node-positive disease. However, radiation conferred survival benefit even when given alone in node-negative disease.
Conclusion: The rate of locoregional recurrence after breast conserving surgery was 10.4%. Adequate surgical margins and nodal disease were independently associated with LR and both radiation and hormonal therapy improved survival. Survival benefit was greatest in women who completed both radiation and 5 years of hormonal therapy.
Recurrence; Wide local excision; Radiation; Hormonal therapy
Cite the article
Chan PMY, Kuah S, Lee JWK, Lee CH, Phua JKS, Chen JJC, et al. Factors Predicting Locoregional Recurrence after Wide Local Excision � Experience from a Tertiary Centre. Clin Surg. 2019; 4: 2382.