Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press5610.17650/1994-4098-2013-0-3-4-45-49MAMMOLOGY. TREATMENTМАММОЛОГИЯ. ЛЕЧЕНИЕRationale for repeat breast-conserving surgery after in-breast recurrence of breast cancerВозможность органосохраняющего лечения местных рецидивов рака молочной железыUimanovV. A.УймановВ. А.
Russian Federation
v.uimanov@mail.ruTrigolosovA. V.ТриголосовА. В.
Russian Federation
PetrovskyA. V.ПетровскийА. В.
Russian Federation
NechushkinM. I.НечушкинМ. И.
Russian Federation
GladilinaI. A.ГладилинаИ. А.
Russian Federation
MolodikovaN. R.МолодиковаН. Р.
Russian Federation
MaslyankinD. B.МаслянкинД. Б.
Russian Federation
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowФГБУ «РОНЦ им. Н.Н.Блохина» РАМН, Москва220920133-4454922072014220720142013https://ojrs.abvpress.ru/ojrs/article/view/56

The main outcomes of our interest were local control and survival of 76 patients with local recurrence of breast cancer treated with conservative surgery (n = 32) or mastectomy (n = 44). There was not statistically significant difference in the probability of 5-years overall (81 %, 64.2 %; p = 0,245) and metastatic-free survival (60.7 %, 57.1 %, p = 0,553), as measured from the recurrence, and in rates of subsequent in-breast (12.5 %) or chest wall (11.4 %) recurrences between women of these two groups respectively. This fact is rationale for repeat breast-conserv- ing surgery in appropriately selected patients and requires further investigations.

Целью нашего исследования было изучение частоты повторного местного рецидивирования и показателей выживаемости у 76 пациенток с местными рецидивами рака молочной железы, по поводу которых им была выполнена или повторная органосох- раняющая операция (n = 32), или мастэктомия (n = 44). Мы не обнаружили статистически значимых различий между этими группами в показателях 5-летней общей выживаемости (81 и 64,2 %, p = 0,245) и безметастатической выживаемости (60,7 и 57,1 %; p = 0,553), а также в частоте повторных местных рецидивов в молочной железе (12,5 %) или в мягких тканях грудной клетки (11,4 %) соответственно. Этот факт дает основание для повторного органосохраняющего лечения местных рецидивов рака молочной железы при наличии соответствующих клинических условий, определение которых требует дальнейших исследований.

breast cancerlocal recurrencesrepeat breast-conserving surgeryрак молочной железыместные рецидивыповторное органосохраняющее лечение1. Burger A.E., Pain S.J., Peley G. Treatment of recurrent breast cancer following breast conserving surgery. Breast J 2013;19(3):310–8.Burger A.E., Pain S.J., Peley G. Treatment of recurrent breast cancer following breast conserving surgery. Breast J 2013;19(3):310–8.2. Alpert T.E., Kuerer H.M., Arthur D.W. 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(3):845–51.Alpert T.E., Kuerer H.M., Arthur D.W. 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(3):845–51.3. Колядина И.В. Локальные рецидивы первично-операбельного рака молочной железы. Дис. ... канд. мед. наук. М., 2009. 110 с.Колядина И.В. Локальные рецидивы первично-операбельного рака молочной железы. Дис. ... канд. мед. наук. М., 2009. 110 с.4. Komoike Y., Akiyama F., Iino Y. et al. Analysis of ipsilateral breast tumor recurrences after breast-conserving treatment based on the classification of true recurrences and new primary tumors. Breast Cancer 2005;12(2):104–11.Komoike Y., Akiyama F., Iino Y. et al. Analysis of ipsilateral breast tumor recurrences after breast-conserving treatment based on the classification of true recurrences and new primary tumors. Breast Cancer 2005;12(2):104–11.5. Salvadori B., Marubini E., Miceli R. et al. Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Br J Surg 1999;86(1):84–7.Salvadori B., Marubini E., Miceli R. et al. Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Br J Surg 1999;86(1):84–7.6. Voogd A.C., van Oost F.J., Rutgers E.J. et al. Dutch Study Group on Local Recurrence after Breast Conservation (BORST Group). Long- term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer. Eur J Cancer 2005;41(17):2637–44.Voogd A.C., van Oost F.J., Rutgers E.J. et al. Dutch Study Group on Local Recurrence after Breast Conservation (BORST Group). Long- term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer. Eur J Cancer 2005;41(17):2637–44.7. Krauss D.J., Kestin L.L., Mitchell C. et al. Changes in temporal patterns of local failure after breast-conserving therapy and their prognostic implications. Int J Radiat Oncol Biol Phys 2004;60(3):731–40.Krauss D.J., Kestin L.L., Mitchell C. et al. Changes in temporal patterns of local failure after breast-conserving therapy and their prognostic implications. Int J Radiat Oncol Biol Phys 2004;60(3):731–40.8. Panet-Raymond V., Truong P.T., Alexander C. et al. Clinicopathologic factors of the recurrent tumor predict outcome in patients with ipsilateral breast tumor recurrence. Cancer 2011;117(10):2035–43.Panet-Raymond V., Truong P.T., Alexander C. et al. Clinicopathologic factors of the recurrent tumor predict outcome in patients with ipsilateral breast tumor recurrence. Cancer 2011;117(10):2035–43.9. Abner A.L., Recht A., Eberlein T. et al. Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early-stage breast cancer. J Clin Oncol 1993;11(1):44–8. 10. Kurtz J.M., Jacquemier J., Amalric R. et al. Is breast conservation after local recurrence feasible? Eur J Cancer 1991;27(3):240–4.Abner A.L., Recht A., Eberlein T. et al. Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early-stage breast cancer. J Clin Oncol 1993;11(1):44–8. 10. Kurtz J.M., Jacquemier J., Amalric R. et al. Is breast conservation after local recurrence feasible? Eur J Cancer 1991;27(3):240–4.11. Komoike Y., Motomura K., Inaji H. et al. Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary results. Oncology 2003;64(1):1–6.Komoike Y., Motomura K., Inaji H. et al. Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary results. Oncology 2003;64(1):1–6.12. Guix B., Henriquez I., Tello J.I. et al. Second conservative treatment as salvage treatment for local recurrences of the breast: 12-year results from a pilot study (abstract). Radiother Oncol 2003;66(Suppl 1):S15.Guix B., Henriquez I., Tello J.I. et al. Second conservative treatment as salvage treatment for local recurrences of the breast: 12-year results from a pilot study (abstract). Radiother Oncol 2003;66(Suppl 1):S15.13. Hannoun-Levi J.M., Houvenaeghel G., Ellis S. et al. Partial breast irradiation as second conservative treatment for local breast cancer recurrence. Int J Radiat Oncol Biol Phys 2004;60(5):1385–92.Hannoun-Levi J.M., Houvenaeghel G., Ellis S. et al. Partial breast irradiation as second conservative treatment for local breast cancer recurrence. Int J Radiat Oncol Biol Phys 2004;60(5):1385–92.14. Chadha M., Feldman S., Boolbol S. et al. The feasibility of a second lumpectomy and breast brachytherapy for localized cancer in a breast previously treated with lumpectomy and radiation therapy for breast cancer. Brachytherapy 2008;7(1):22–8.Chadha M., Feldman S., Boolbol S. et al. The feasibility of a second lumpectomy and breast brachytherapy for localized cancer in a breast previously treated with lumpectomy and radiation therapy for breast cancer. Brachytherapy 2008;7(1):22–8.15. Trombetta M., Julian T.B., Werts D.E. et al. Long-term cosmesis after lumpectomy and brachytherapy in the management of carcinoma of the previously irradiated breast. Am J Clin Oncol 2009;32(3):314–8.Trombetta M., Julian T.B., Werts D.E. et al. Long-term cosmesis after lumpectomy and brachytherapy in the management of carcinoma of the previously irradiated breast. Am J Clin Oncol 2009;32(3):314–8.