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Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning.

Publication ,  Journal Article
Yi, M; Buchholz, TA; Meric-Bernstam, F; Bedrosian, I; Hwang, RF; Ross, MI; Kuerer, HM; Luo, S; Gonzalez-Angulo, AM; Buzdar, AU; Symmans, WF ...
Published in: Ann Surg
March 2011

OBJECTIVE: To classify ipsilateral breast tumor recurrences (IBTR) as either new primary tumors (NP) or true local recurrence (TR). We utilized 2 different methods and compared sensitivities and specificities between them. Our goal was to determine whether distinguishing NP from TR had prognostic value. BACKGROUND: After breast-conservation therapy, IBTR may be classified into 2 distinct types (NP and TR). Studies have attempted to classify IBTR by using tumor location, histologic subtype, DNA flow cytometry data, or gene-expression profiling data. METHODS: A total of 447 (7.9%) of 5660 patients undergoing breast-conservation therapy from 1970 to 2005 experienced IBTR. Clinical data from 397 patients were available for review. We classified IBTRs as NP or TR on the basis of either tumor location and histologic subtype (method 1) or tumor location, histologic subtype, estrogen receptor status and human epidermal growth factor receptor 2 status (method 2). Kaplan-Meier curves and log-rank tests were used to evaluate overall and disease-specific survival differences between the 2 groups. Classification methods were validated by calculating sensitivity and specificity values using a Bayesian method. RESULTS: Of 397 patients, 196 (49.4%) were classified as NP by method 1 and 212 (53.4%) were classified as NP by method 2. The sensitivity and specificity values were 0.812 and 0.867 for method 1 and 0.870 and 0.800 for method 2, respectively. Regardless of method used, patients classified as NP developed contralateral breast carcinoma more often but had better 10-year overall and disease-specific survival rates than those classified as TR. Patients with TR were more likely to develop metastatic disease after IBTR. CONCLUSION: Ipsilateral breast tumor recurrences classified as TR and NP had clinically different features, suggesting that classifying IBTR may provide clinically significant data for the management of IBTR.

Duke Scholars

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

March 2011

Volume

253

Issue

3

Start / End Page

572 / 579

Location

United States

Related Subject Headings

  • Surgery
  • Reoperation
  • Prognosis
  • Patient Care Planning
  • Neoplasms, Second Primary
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mastectomy, Segmental
  • Humans
  • Gene Expression Profiling
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yi, M., Buchholz, T. A., Meric-Bernstam, F., Bedrosian, I., Hwang, R. F., Ross, M. I., … Hunt, K. K. (2011). Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning. Ann Surg, 253(3), 572–579. https://doi.org/10.1097/SLA.0b013e318208fc2a
Yi, Min, Thomas A. Buchholz, Funda Meric-Bernstam, Isabelle Bedrosian, Rosa F. Hwang, Merrick I. Ross, Henry M. Kuerer, et al. “Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning.Ann Surg 253, no. 3 (March 2011): 572–79. https://doi.org/10.1097/SLA.0b013e318208fc2a.
Yi M, Buchholz TA, Meric-Bernstam F, Bedrosian I, Hwang RF, Ross MI, et al. Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning. Ann Surg. 2011 Mar;253(3):572–9.
Yi, Min, et al. “Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning.Ann Surg, vol. 253, no. 3, Mar. 2011, pp. 572–79. Pubmed, doi:10.1097/SLA.0b013e318208fc2a.
Yi M, Buchholz TA, Meric-Bernstam F, Bedrosian I, Hwang RF, Ross MI, Kuerer HM, Luo S, Gonzalez-Angulo AM, Buzdar AU, Symmans WF, Feig BW, Lucci A, Huang EH, Hunt KK. Classification of ipsilateral breast tumor recurrences after breast conservation therapy can predict patient prognosis and facilitate treatment planning. Ann Surg. 2011 Mar;253(3):572–579.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

March 2011

Volume

253

Issue

3

Start / End Page

572 / 579

Location

United States

Related Subject Headings

  • Surgery
  • Reoperation
  • Prognosis
  • Patient Care Planning
  • Neoplasms, Second Primary
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mastectomy, Segmental
  • Humans
  • Gene Expression Profiling