Background: Since 1992 conservative treatment of breast cancer (stage I and II: clinical TNM) has been established as an alternative to mastectomy in our hospital. The aim of this retrospective study was to analyse locoregional recurrence features and to compare prognosis with regard to to site of recurrence.
Method: Between 1987 and 1993, 489 patients with breast cancer (stages I and II) were treated with conservative surgery and radiation therapy at the Hospital Sant Pau of Barcelona. Mean follow-up was 58.8 months [between 12-144]. 35 patients developed locoregional recurrence. We considered two groups: local recurrence in breast only; and locoregional recurrence such as nodal recurrence with or without simultaneous breast recurrence. Diagnosis was confirmed by histopathologic analysis. An extensive study was performed in all patients to rule out distant metastasis. Last follow-up was December 1999.
Results: The locoregional recurrence rate after conservative treatment was 7.5% and that of local recurrence was 3.06%. Recurrences were diagnosed in 80% of patients by physical examination, while 20% of patients had noticed the tumor recurrence themselves. Histologic grade III tumors had a higher number of locoregional recurrences than local recurrences (p = 0.030). Locoregional recurrences had lower overall survival rate (p = 0.0005), lower disease-free survival rate (p = 0.0012) and shorter time period without distant metastasis (p < 0.0005) than local recurrences.
Conclusions: Most recurrences were diagnosed by clinical examination during follow up. Histologic grade III was related to locoregional recurrences. Local recurrences had a better prognosis than locoregional recurrences.