BREAST-CANCER RECURRENCE AFTER LUMPECTOMY AND RADIATION-THERAPY FOR EARLY-STAGE DISEASE - PROGNOSTIC-SIGNIFICANCE OF DETECTION METHOD

The prognostic implications of detection mode in local recurrence afte r lumpectomy and radiation therapy were assessed. Seventy-two women tr eated with lumpectomy and irradiation for American Joint Committee on Cancer stages I and II invasive breast cancer developed recurrent canc er in the ipsilateral breast, had physical examination and mammography performed at the time of recurrence, and underwent salvage mastectomy . There was a statistically significant association between detection with mammography alone and lower T stage (P = .05), and there was a no nstatistically significant trend toward noninvasive histologic finding s. No significant association was noted between detection method and s ite of recurrent cancer in the breast, interval to recurrence, or pati ent age. There were nonstatistically significant trends toward improve d relapse-free survival and overall survival for patients with recurre nces detected solely with mammography. These results demonstrate that postirradiation surveillance mammography is important for the early de tection of recurrent cancer. While the trend did not reach statistical significance, detection with mammography alone had a clinically appar ent impact on relapse-free and overall survival.