Immunohistochemical study on primary and recurrent tumors in patients withlocal recurrence in the conserved breast

One hundred and seventy patients received breast-conserving therapy in the Second Department of Surgery, Gunma University School of Medicine. Six (3.5 %) out of the 170 patients showed breast recurrence. We investigated the br east recurrent cases clinicopathologically. The age at the initial operatio n ranged from 38 to 78 (mean 57) years. One patient was clinical stage I an d the others were clinical stage II. Surgical margin at the initial operati on was negative in two patients and positive in four. Histological type was invasive ductal cancer in all cases. Three patients had lymph node involve ment. The interval from the initial operation to breast recurrence ranged f rom 19 to 68 months. Five cases were nodular type and one was diffuse type of breast recurrence. Histological type of breast recurrence was the same a s the initial one. We performed salvage surgery for all breast recurrent pa tients, mastectomy for four patients and local resection for two. One patie nt who showed diffuse type of recurrence could not be controlled with any s urgical treatment, and later died of breast cancer. We investigated the exp ression of estrogen receptor, progesterone receptor, pS2, c-erbB-2 and p53 on both initial and recurrent specimens of the six patients. The expression of each protein on the recurrent specimens was the same as the initial one . We conclude that. breast recurrence after breast-conserving therapy has i ts origin in the residue of cancer cells at the initial operation, even if surgical margins are histopathologically negative.