Method of Detection of Method of Detection of Ipsilateral Breast Tumor Ipsilateral Breast Tumor Recurrence Following Breast Recurrence Following Breast Conserving Therapy is a Conserving Therapy is a Predictor of Distant Predictor of Distant MetastasesMetastases R Tuli MD PhD, JP Christodouleas MD MPH, L Roberts, SJ Deol, DA R Tuli MD PhD, JP Christodouleas MD MPH, L Roberts, SJ Deol, DA Frassica MD, Frassica MD,

RC Zellars MD, KY Usuki MD, KL Brill MD, AL Rosenberg MDRC Zellars MD, KY Usuki MD, KL Brill MD, AL Rosenberg MD

BackgroundBackground Current clinical guidelines suggest the method

of detection (clinical vs. radiographic) of ipsilateral breast tumor recurrence (IBTR) following breast conserving therapy (BCT) does not influence survival

Controversy exists regarding the optimal surveillance of such patients

PurposePurpose We attempt to determine the prognostic

significance of method of detection of IBTR on distant metastases (DM)-free survival

Author Disclosures: None

MethodsMethods IRB approved, retrospective single institution

chart review of all newly diagnosed breast cancer patients

Treated with BCT between 1981 and 2007 We identified patients who subsequently

developed IBTR Charts reviewed for:

Demographics Clinical presentation Method of detection Stage Type of therapy Histopathology Margin status (primary and recurrent tumors)

All patients presenting with DM following BCT or a suspected new primary with different histology following BCT were excluded

Median follow-up from time of recurrence 27 months (1 to 231)

Median time from IBTR to DM was 151 months

5-year DM-free survival following IBTR was 69.5%

ResultsResults

ResultsResults Univariate analysis of pt/tumor characteristics on DM-free survival

Contrary to previous reports, clinical detection of local recurrence remains a significant risk factor for time to DM

In contrast, radiographic detection of such recurrences confers a higher DM-free survival

These results support the necessity for regular and timely radiographic evaluations following IBTR in patients previously treated with BCT

Median DM-free survival for clinically and radiographically detected IBTRs was 54 months and > 231 months (median was not reached), respectively

On multivariate Cox regression analysis, clinically detected IBTRs remained a significant predictor of lower DM-free survival

Adjusted relative risk for clinically detected IBTRs was 2.2

ResultsResults

ConclusionsConclusions