Recurrence rates in patients with central or retroareolar breast cancers treated with mastectomy or lumpectomy

Background: Although breast conservation with lumpectomy and radiation trea tment has become a commonly used treatment for breast cancer, there are lit tle data to support the use of lumpectomy for central and retroareolar brea st cancers. In this study, we investigate the local and distant recurrence rates of patients with central or retroareolar breast cancers treated with lumpectomy compared with mastectomy Methods: This study provides a retrospective analysis of 99 patients, from 1981 to 2000, with central or retroareolar breast cancers treated with mast ectomy or lumpectomy to determine the frequency of local and distant recurr ence. The mastectomy and lumpectomy patients were compared with respect to recurrence and other prognostic factors including: tumor location, tumor si ze, axillary nodal status, and final surgical margins. Results: The overall frequency of local recurrence was 5 of 99 (5.0%) in th e entire group, 3 of 67 (4.5%) and 2 of 32 (6.3%) of patients who underwent mastectomy and lumpectomy, respectively (P >0.99). Overall, 3 patients exp erienced a distant recurrence as a first event, with 2 patients (3.0%) in t he mastectomy group and I patient (3.1%) in the lumpectomy group (P >0.99). The type of surgical management was not statistically significant related to either local or distant disease recurrence, with median time to local re currence of 3.0 years for the mastectomy patients and 5.0 years for lumpect omy patients. Of the patients with central tumors who underwent mastectomy 2 of 42 (4.8%) developed local recurrences compared with those who had a lu mpectomy, I of 21 (4.8%). Similarly for retroareolar tumors, the local recu rrence rate was I of 25 (4.0%) for patients undergoing mastectomy and I of 11 (9.1%) for those undergoing lumpectomy (P >0.99). Conclusions: In this study there was no significant difference in local or distant failure rates of those patients with central or retroareolar tumors treated with mastectomy versus lumpectomy. We conclude lumpectomy to be a reasonable treatment option for selected patients with central or retroareo lar breast cancers. (C) 2001 Excerpta Medica, Inc. All rights reserved.