Prognosis for isolated skin recurrence after breast cancer treated by mastectomy.

UNLABELLED Isolated skin recurrence after mastectomy (ISRAM) for breast cancer is a rare event for which treatment is difficult and subject to debate. PATIENTS AND METHODS The records of 75 patients presenting with ISRAM were reviewed retrospectively. The factors liable to affect recurrence prognosis were analyzed, and included both factors related to the primary tumor and its treatment and those related to the recurrence itself. RESULTS The size of the primary tumor is correlated with the inflammatory nature of the recurrence as well as overall survival. Metastatic lymph node involvement also affects the risk of inflammatory recurrence and is correlated with overall survival. Salvage mastectomy for local recurrence after primary breast-conserving surgery followed by ISRAM has a poor prognosis in terms of recurrence-free survival, and chest wall radiotherapy after primary mastectomy reduces the risk of metastatic development after ISRAM. When confronted with ISRAM, 2 factors affect prognosis: the inflammatory nature of the recurrence impairs overall survival and chest wall radiotherapy reduces the risk of secondary systemic disease. CONCLUSION these results underline the importance of good local control when treating the primary tumor (to reduce the risk of ISRAM occurrence, and improve its prognosis if it occurs) and the advantage of locoregional and systemic treatment in the presence of ISRAM and in particular its inflammatory presentation.