scholarly journals Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Juliana Rodrigues Tovar ◽  
Eliana Zandonade ◽  
Maria Helena Costa Amorim
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Early Stage ◽  
Surgical Margin ◽  
Conservative Surgery ◽  
Local Recurrences ◽  
Unified Health System ◽  
Her 2 ◽  
Clinical Profiles ◽  
The Mean

Conservative surgery is considered the procedure of choice for women who are affected by early stage tumours. The local recurrence of cancer as a consequence of breast tissue conservation is a growing concern. This study aimed to describe the sociodemographic and clinical profiles of women who had local recurrences of breast cancer after conservative surgery and to examine the associations between sociodemographic and clinical variables and the incidence of tumour recurrence in these women. The retrospective cohort included 880 women who were diagnosed with breast cancer and underwent conservative surgery between January 2000 and December 2010. Recurrences occurred in 60 patients, and the mean age of the women at diagnosis was 48.8 years. Predictive factors for local recurrence were young age (<39 years) (P=0.028andOR=10.93), surgical margin involvement (P=0.001andOR=3.66), and Her-2 overexpression (P=0.045andOR=1.94). The establishment of sociodemographic and clinical characteristics might help to select optimum treatments, which is a crucial challenge for public health in Brazil, especially with regard to reductions of surgery and hospitalisation expenditures in the Unified Health System (Sistema Único de Saúde—SUS).

Patient preferences concerning the trade-off between the risks and benefits of routine radiation therapy after conservative surgery for early-stage breast cancer.

1997 ◽  
Vol 15 (3) ◽  
pp. 1252-1260 ◽  
Author(s):  
J A Hayman ◽  
D L Fairclough ◽  
J R Harris ◽  
J C Weeks
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Local Recurrence ◽  
Early Stage ◽  
Conservative Surgery ◽  
Sociodemographic Factors ◽  
Early Stage Breast Cancer ◽  
Health States ◽  
Trade Off ◽  
Risks And Benefits

PURPOSE To assess patients' preferences regarding the trade-off between risks and benefits of radiation therapy after conservative surgery for early-stage breast cancer. PATIENTS AND METHODS Utilities (measures of preference) of 97 early-stage breast cancer patients treated with conservative surgery and radiation therapy and 20 medical oncology nurses were assessed for five health states using standard gambles. RESULTS Patients had the highest mean utility for treatment with conservative surgery and radiation therapy without a local recurrence (0.92), intermediate utilities for treatment with conservative surgery alone followed either by no local recurrence or by a local recurrence salvaged by conservative surgery and radiation therapy (0.88 and 0.87, respectively), and the lowest utilities for treatment with or without radiation therapy followed by a local recurrence salvaged by mastectomy and reconstructive surgery (0.82 and 0.81, respectively). All differences between health states' utilities were significant (P < .0001), except between the two intermediate and two lowest rated health states. None of the clinical or sociodemographic factors examined explained more than 5% of the variability in the patients' utilities or their differences. Nurses' utilities were similar to those of the patients. CONCLUSIONS These results strongly suggest that fear of a local recurrence and an actual local recurrence leading to mastectomy have such a negative impact on quality of life that patients are willing to accept the risks and inconvenience of radiation therapy to avoid them. There is also considerable interpatient variability that was not explained by the clinical or sociodemographic factors examined.

Time-course of local recurrence following conservative surgery and radiotherapy for early stage breast cancer

1988 ◽  
Vol 15 (2) ◽  
pp. 255-261 ◽  
Author(s):  
Abram Recht ◽  
William Silen ◽  
Stuart J. Schnitt ◽  
James L. Connolly ◽  
Rebecca S. Gelman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Time Course ◽  
Early Stage ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer

Cost-effectiveness of routine radiation therapy following conservative surgery for early-stage breast cancer.

1998 ◽  
Vol 16 (3) ◽  
pp. 1022-1029 ◽  
Author(s):  
J A Hayman ◽  
B E Hillner ◽  
J R Harris ◽  
J C Weeks
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Radiation Therapy ◽  
Cost Effectiveness ◽  
Local Recurrence ◽  
Early Stage ◽  
Cost Effective ◽  
Conservative Surgery ◽  
The Cost

PURPOSE To examine the cost-effectiveness of radiation therapy following conservative surgery for early-stage breast cancer. METHODS Using a Markov model, a cost-utility analysis was performed to compare a strategy of radiation therapy versus no radiation therapy in a hypothetical cohort of 60-year-old women following conservative surgery. Local recurrence, distant recurrence, and survival rates used in the model were derived from randomized trial data. Utilities for the nonmetastatic health states were collected from actual patients. Direct medical costs were estimated using data from a single institution. Transportation and time costs were also estimated. Years of life, quality-adjusted life-years (QALYs), costs, and incremental cost/QALY over a 10-year time horizon were calculated by the model for each strategy. RESULTS The addition of radiation therapy results in a cost increase of $9,800 per patient, no change in life expectancy, and an increase of 0.35 QALYs per patient, which leads to an incremental cost-effectiveness ratio of $28,000/QALY, which is well below $50,000/QALY, a commonly cited threshold for cost-effective care. Sensitivity analysis shows the ratio to be heavily influenced by the cost of radiation therapy and the quality-of-life benefit that results from decreased risk of local recurrence. CONCLUSION Radiation therapy following conservative surgery is cost-effective compared with other accepted medical interventions. This study illustrates the importance of considering an intervention's effect on quality of life, as well as survival in defining cost-effectiveness.

Prognosis after local recurrence after conservative surgery and radiation for early-stage breast cancer

2005 ◽  
Vol 61 (2) ◽  
pp. 348-357 ◽  
Author(s):  
Sharon Galper ◽  
Emily Blood ◽  
Rebecca Gelman ◽  
Anthony Abner ◽  
Abram Recht ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Early Stage ◽  
Conservative Surgery ◽  
Early Stage Breast Cancer

Prognosis of patients with local recurrence after mastectomy or conservative surgery for early-stage invasive breast cancer

The Breast ◽  
2008 ◽  
Vol 17 (3) ◽  
pp. 302-308 ◽  
Author(s):  
J. Fodor ◽  
T. Major ◽  
C. Polgár ◽  
Z. Orosz ◽  
Z. Sulyok ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Invasive Breast Cancer ◽  
Early Stage ◽  
Conservative Surgery

scholarly journals Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1161
Author(s):  
Lidia Delrieu ◽  
Liacine Bouaoun ◽  
Douae El Fatouhi ◽  
Elise Dumas ◽  
Anne-Deborah Bouhnik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Latent Class ◽  
Early Stage ◽  
Current Analysis ◽  
Functional Pain ◽  
Cognitive Sequelae ◽  
History Of ◽  
The Mean ◽  
Study Participants ◽  
Changes Over Time

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey “vie après cancer” VICAN (January–June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified—functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.

scholarly journals Loco-regional recurrence trend and prognosis in young women with breast cancer according to molecular subtypes: analysis of 1099 cases

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yang Li ◽  
Su Lu ◽  
Yuhan Zhang ◽  
Shuaibing Wang ◽  
Hong Liu
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Molecular Subtypes ◽  
Early Stage ◽  
Young Patients ◽  
Distant Metastases ◽  
Early Stage Breast Cancer ◽  
Regional Recurrence ◽  
Her2 Status ◽  
Over Time

Abstract Background The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusions The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.

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