AGGRESSIVE THERAPY FOR LOCOREGIONAL RECURRENCE AFTER MASTECTOMY IN STAGE-II AND STAGE-III BREAST-CANCER PATIENTS

Background: To determine if aggressive treatment of locoregional recur rence affects survival, we retrospectively analyzed the clinical outco me of 69 breast cancer patients who developed locoregional disease as their first episode of recurrence following mastectomy and adjuvant ch emotherapy. Methods: Patients were identified from among 1,707 stage I I and III breast cancer patients who enrolled in five different doxoru bicin-based adjuvant chemotherapy protocols at The University of Texas M. D. Anderson Cancer Center from 1975 to 1986. Sixty-nine evaluable patients who had a locoregional recurrence as the first site of relaps e after mastectomy formed the study group. Multifactorial analysis of clinical and histopathological characteristics of both the primary tum or and the subsequent recurrence was performed using a logistic regres sion method. Survival analysis was performed using an actuarial life-t able method calculated from the date of registration into the adjuvant therapy protocols. Results: Median follow-up was 6.6 years. Two facto rs significantly affected survival: recurrence of disease during or af ter adjuvant treatment of the primary and whether the patient was rend ered disease free after recurrence. Conclusions: Stage II and III brea st cancer patients who have locoregional recurrence after adjuvant che motherapy and can be rendered disease free may have a better survival rate. Aggressive treatment of locoregional recurrence including comple te surgical excision should be considered in this subgroup of patients .