Prognosis of Isolated Local Recurrence after Modified Radical Mastectomy for Early Breast Cancer

Purpose: Isolated local recurrence (ILR) after mastectomy is associated with increased risk of cancer-specific survival. This study evaluated the long-term survival and prognostic factors after ILR. Methods: Between January 1988 and December 2004, 1,169 patients with early breast cancer (stage I or II) were treated with modified radical mastectomy at Kyungpook hospital. Retrospectively, 40 patients with isolated local recurrence (ILR) were found by medical records and we investigated their clinicopathologic factors and conducted analyses of prognostic factors, calculated overall survival, and relapse-free survival. Results: The median follow-up times after initial operation and ILR were each 91 (range, 18∼219) months and 40 (range, 1∼205) months. There were 18 patients of 2nd recurrence and 15 expired by distant metastasis. The overall survivals at 5 years and 10 years after ILR were 65% and 49%. The relapse-free survivals at 5 years and 10 years after ILR were 54% and 29%. After 2nd recurrence, the mean survival time was 21 months and the 3-year overall survival rate was 21%. By univariate and multivariate analyses, the time interval between initial operation and ILR was only statistically significant independent prognostic factor of overall survival after ILR. The 10 year-overall survival rates of ≤24 months and >24 months to ILR were each 26% and 70%. There was no independent prognostic factor of relapse-free survival after ILR. Conclusion: For patients who developed isolated local recurrence after modified radical mastectomy for early breast cancer, shorter time interval to ILR is a poor prognostic factor of overall survival after ILR. (J Korean Surg Soc 2009;76:293-300)