Isolated axillary recurrences after conservative treatment of breast cancer.
Identifieur interne : 005194 ( PubMed/Curation ); précédent : 005193; suivant : 005195Isolated axillary recurrences after conservative treatment of breast cancer.
Auteurs : C. Renolleau [France] ; P. Merviel ; K B Clough ; B. Asselain ; F. Campana ; J C DurandSource :
- European journal of cancer (Oxford, England : 1990) [ 0959-8049 ] ; 1996.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Association thérapeutique, Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Irradiation ganglionnaire (effets indésirables), Lymphadénectomie, Métastase lymphatique (anatomopathologie), Récidive tumorale locale, Taux de survie, Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Études rétrospectives.
- MESH :
- anatomopathologie : Métastase lymphatique, Tumeurs du sein.
- effets indésirables : Irradiation ganglionnaire.
- Adulte d'âge moyen, Association thérapeutique, Facteurs de l'âge, Facteurs de risque, Femelle, Humains, Lymphadénectomie, Récidive tumorale locale, Taux de survie, Tumeurs du sein, Études rétrospectives.
English descriptors
- KwdEn :
- Age Factors, Breast Neoplasms (pathology), Breast Neoplasms (therapy), Combined Modality Therapy, Female, Humans, Lymph Node Excision, Lymphatic Irradiation (adverse effects), Lymphatic Metastasis (pathology), Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Risk Factors, Survival Rate.
- MESH :
- adverse effects : Lymphatic Irradiation.
- pathology : Breast Neoplasms, Lymphatic Metastasis.
- therapy : Breast Neoplasms.
- Age Factors, Combined Modality Therapy, Female, Humans, Lymph Node Excision, Middle Aged, Neoplasm Recurrence, Local, Retrospective Studies, Risk Factors, Survival Rate.
Abstract
This retrospective study presents the diagnostic, prognostic and therapeutic problems raised by axillary recurrences (AR). 1589 cases of breast cancer measuring less than 3 cm, treated at the Institut Curie between 1981 and 1987, were studied by a combination of surgery and radiotherapy. Treatment of the breast always included wide local excision associated with irradiation. The axilla was treated either by dissection (865 cases) or by irradiation (724 cases) and 159 patients received chemotherapy. 26 patients (2%) developed AR, confirmed by fine needle aspiration cytology in 92% of cases. None of these 26 patients had initially received chemotherapy. The treatment of the AR was variable, adapted to the initial treatment. 22 patients retained their breast during treatment of the AR and none subsequently developed a local recurrence. 4 mastectomies were performed and histological examination revealed a subclinical local recurrence in 2 cases. The TNM classification, menopausal status, size of the tumour and hormonal receptor status were not risk factors for AR. Young age (P = 0.01) and high histological grade (P = 0.03) were significant risk factors for AR. The AR rate was similar whether axillary dissection or axillary irradiation had been performed. The overall 5-year survival after initial treatment was 85% for AR and 95% for the reference population. The overall 4-year survival after recurrence was 69% and the incidence of metastasis was markedly increased (P = 0.002). 2 of the 26 patients developed lymphoedema of the arm after treatment of AR. We confirm that AR worsens the prognosis, but not significantly more than local recurrence. Young age and the modified histological grading of Scarff Bloom and Richardson were risk factors for AR. Although excision of the AR is necessary to ensure local control, mastectomy is unnecessary when clinical examination and mammography are normal.
PubMed: 8695263
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Treatment of the breast always included wide local excision associated with irradiation. The axilla was treated either by dissection (865 cases) or by irradiation (724 cases) and 159 patients received chemotherapy. 26 patients (2%) developed AR, confirmed by fine needle aspiration cytology in 92% of cases. None of these 26 patients had initially received chemotherapy. The treatment of the AR was variable, adapted to the initial treatment. 22 patients retained their breast during treatment of the AR and none subsequently developed a local recurrence. 4 mastectomies were performed and histological examination revealed a subclinical local recurrence in 2 cases. The TNM classification, menopausal status, size of the tumour and hormonal receptor status were not risk factors for AR. Young age (P = 0.01) and high histological grade (P = 0.03) were significant risk factors for AR. The AR rate was similar whether axillary dissection or axillary irradiation had been performed. The overall 5-year survival after initial treatment was 85% for AR and 95% for the reference population. The overall 4-year survival after recurrence was 69% and the incidence of metastasis was markedly increased (P = 0.002). 2 of the 26 patients developed lymphoedema of the arm after treatment of AR. We confirm that AR worsens the prognosis, but not significantly more than local recurrence. Young age and the modified histological grading of Scarff Bloom and Richardson were risk factors for AR. Although excision of the AR is necessary to ensure local control, mastectomy is unnecessary when clinical examination and mammography are normal.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">8695263</PMID><DateCreated><Year>1996</Year><Month>09</Month><Day>05</Day></DateCreated><DateCompleted><Year>1996</Year><Month>09</Month><Day>05</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0959-8049</ISSN><JournalIssue CitedMedium="Print"><Volume>32A</Volume><Issue>4</Issue><PubDate><Year>1996</Year><Month>Apr</Month></PubDate></JournalIssue><Title>European journal of cancer (Oxford, England : 1990)</Title><ISOAbbreviation>Eur. J. Cancer</ISOAbbreviation></Journal><ArticleTitle>Isolated axillary recurrences after conservative treatment of breast cancer.</ArticleTitle><Pagination><MedlinePgn>617-21</MedlinePgn></Pagination><Abstract><AbstractText>This retrospective study presents the diagnostic, prognostic and therapeutic problems raised by axillary recurrences (AR). 1589 cases of breast cancer measuring less than 3 cm, treated at the Institut Curie between 1981 and 1987, were studied by a combination of surgery and radiotherapy. Treatment of the breast always included wide local excision associated with irradiation. The axilla was treated either by dissection (865 cases) or by irradiation (724 cases) and 159 patients received chemotherapy. 26 patients (2%) developed AR, confirmed by fine needle aspiration cytology in 92% of cases. None of these 26 patients had initially received chemotherapy. The treatment of the AR was variable, adapted to the initial treatment. 22 patients retained their breast during treatment of the AR and none subsequently developed a local recurrence. 4 mastectomies were performed and histological examination revealed a subclinical local recurrence in 2 cases. The TNM classification, menopausal status, size of the tumour and hormonal receptor status were not risk factors for AR. Young age (P = 0.01) and high histological grade (P = 0.03) were significant risk factors for AR. The AR rate was similar whether axillary dissection or axillary irradiation had been performed. The overall 5-year survival after initial treatment was 85% for AR and 95% for the reference population. The overall 4-year survival after recurrence was 69% and the incidence of metastasis was markedly increased (P = 0.002). 2 of the 26 patients developed lymphoedema of the arm after treatment of AR. We confirm that AR worsens the prognosis, but not significantly more than local recurrence. Young age and the modified histological grading of Scarff Bloom and Richardson were risk factors for AR. Although excision of the AR is necessary to ensure local control, mastectomy is unnecessary when clinical examination and mammography are normal.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Renolleau</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Chirurgie Générale, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Merviel</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Clough</LastName><ForeName>K B</ForeName><Initials>KB</Initials></Author><Author ValidYN="Y"><LastName>Asselain</LastName><ForeName>B</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Campana</LastName><ForeName>F</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Durand</LastName><ForeName>J C</ForeName><Initials>JC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur J Cancer</MedlineTA><NlmUniqueID>9005373</NlmUniqueID><ISSNLinking>0959-8049</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015182" MajorTopicYN="N">Lymphatic Irradiation</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008207" MajorTopicYN="N">Lymphatic Metastasis</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009364" MajorTopicYN="Y">Neoplasm Recurrence, Local</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015996" MajorTopicYN="N">Survival Rate</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1996</Year><Month>4</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1996</Year><Month>4</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1996</Year><Month>4</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">8695263</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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