Distant and Locoregional Recurrence in Stage II or III Breast Cancer
Posted: Friday, March 16, 2018
Synchronous distant recurrence was identified in 27% of women experiencing locoregional recurrence, according to a stage-stratified random sample of 11,046 patients diagnosed with stage II or III breast cancer between 2006 and 2007. These findings were reported by Heather B. Neuman, MD, of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues in the Journal of Clinical Oncology.
“These findings support current recommendations for systemic imaging in the setting of locoregional recurrence, particularly for patients with lymph node or chest wall recurrences,” the investigators revealed. “Because most patients with isolated locoregional recurrence will be recommended locoregional treatment, early identification of distant metastases through routine systemic imaging may spare them treatments unlikely to extend their survival.”
Patients who experienced locoregional recurrence within 5 years of diagnosis and synchronous distant metastases within 30 days of locoregional recurrence were identified from the National Cancer Database for participation in this American College of Surgeons Commission on Cancer project.
Locoregional recurrence occurred in 4% of patients (n = 445), and synchronous distant metastases were identified in 27% of those patients (n = 120). The rate of synchronous metastases was highest for women with lymph node (35%), postmastectomy chest wall (30%), and in-breast (15%) recurrence. Additionally, multivariate analysis revealed that initial presenting stage, locoregional recurrence type, and insurance status were all associated with an increased risk for synchronous distant metastases.