[Local treatment of ipsilateral breast cancer recurrences: comparison of alternative therapeutic options].

Magyar onkologia Pub Date : 2024-03-14 Epub Date: 2024-01-30
Viktor Smanykó
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Abstract

We compared the clinical outcomes of second breast conserving therapy (2ndBCT) versus salvage mastectomy (sMT) for the treatment of ipsilateral breast tumour recurrences (IBTR). 195 patients who presented with an IBTR after previous breast conserving treatment were salvaged either with re-excision and perioperative interstitial brachytherapy (n=39) or sMT (n=156). A total dose of 5×4.4Gy was delivered to the tumour bed, on 3 consecutive days. The median follow-up time was 59 and 56 months. During follow-up 4 (10.2%) and 28 (17.9%) second local recurrences occurred after 2ndBCT and sMT, respectively. There were no significant differences between treatments in 5-year oncological outcomes (local and regional recurrence-free survival, disease- and metastasis-free survival, cancer-specific and overall survival). After 2ndBCT, the rate of good to excellent cosmesis was 70%. 2ndBCT is a safe and feasible option for the management of IBTR, resulting similar 5-year oncological outcomes and better cosmetic results compared to sMT.

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[同侧乳腺癌复发的局部治疗:替代疗法的比较]。
我们比较了二次保乳疗法(2ndBCT)与挽救性乳房切除术(sMT)治疗同侧乳腺肿瘤复发(IBTR)的临床效果。195 名患者在接受了前一次保乳治疗后出现了 IBTR,他们要么接受了再次切除术和围手术期间质近距离放射治疗(39 人),要么接受了挽救性乳房切除术(156 人)。连续3天向肿瘤床投放5×4.4Gy的总剂量。中位随访时间分别为59个月和56个月。随访期间,第2次BCT和sMT治疗后分别有4例(10.2%)和28例(17.9%)二次局部复发。不同治疗方法的 5 年肿瘤学结果(无局部和区域复发生存率、无疾病和无转移生存率、癌症特异性生存率和总生存率)无明显差异。第 2 次 BCT 治疗后,外观良好到极佳的比例为 70%。第2次BCT是治疗IBTR的一种安全可行的方法,与sMT相比,其5年肿瘤治疗效果相似,美容效果更好。
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