Skip to main content
SpringerLink
Log in

Lokoregionales Rezidiv

  • Conference paper
Digitale Revolution in der Chirurgie

Part of the book series: Deutsche Gesellschaft für Chirurgie ((KONGRESSBAND,volume 2002))

  • 14 Accesses

Summary

The different options of the therapeutic strategies for the local recurrence of breast cancer has not been evaluated in detail so far. 10% of the patients with local resection of malignant tumors of the breast do develop a local recurrence.

In all cases with local resection of the tumor total excision (R0-resection) is mandatory. In the case of local recurrence a total mastectomy should be performed. Postoperative radiotherapy is only indicated if this has not been performed previously. A second additional radiotherapy is not generally advocated,. The value of chemotherapy has to be confirmed in clinical trials. Patients with receptor positive recurrence should undergo a hormonal therapy.

Zusammenfassung

Die Therapieoptionen für das Lokalrezidiv beim Mammakarzinom sind bisher nur ungenügend evaluiert worden. Nach einer brusterhaltenden Therapie ist in etwa 10% mit einem In-Brust-Rezidiv zu rechnen.

Bei der chirurgischen Therapie ist eine RO-Resektion anzustreben. Beim In-Brust-Rezidiv wird die Mastektomie bevorzugt. Erfolgte primär keine Strahlentherapie, so ist diese indiziert. Eine nochmalige Strahlentherapie ist umstritten. Die Wertigkeit einer Chemotherapie muß noch durch Studien belegt werden. Patientinnen mit rezeptorpositiven Rezidiven sollten eine hormonelle Therapie erhalten.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Borner M, Bacchi M, Goldhirsch A, Greiner R, Harder F, Castiglione M, Jungi WF, Thurlimann B, Cavalli F, Obrecht JP (1994) First isolated locoregional recurrence following mastectomy for breast cancer: results of a phase III multicenter study comparing systemic treatment with observation after excision and radiation. Swiss Group for Clinical Cancer Research. J Clin Oncol 12:2071–2077

    PubMed  CAS  Google Scholar 

  2. Brekelmans CT, Voogd AC, Botke G, van Geel BN, Rodrigus P, Rutgers EJ, Klijn JG, Coebergh JW (1999) Family history of breast cancer and local recurrence after breast-conserving therapy. The Dutch Study Group on Local Recurrence after Breast Conservation (BORST). Eur J Cancer 35:620–626

    Article  PubMed  CAS  Google Scholar 

  3. Bremer M, Steinmann D, Dork T, Borger J, Rades D, Karstens JH (2001) Bilaterales Mammakarzinom und Lokalrezidiv: Prävalenz von BRCA-1 und BRCA-2 Genemutationen an einem unselektionierten Kollektiv. Strahlenther Onkol 177:325–329

    Article  PubMed  CAS  Google Scholar 

  4. Buchholz TA, Tucker SL, Masullo L, Kuerer HM, Erwin J, Salas J, Frye D, Strom EA, McNeese MD, Perkins G, Katz A, Singletary SE, Hunt KK, Buzdar AU, Hortobagyi GN (2002) Predictors of local-regional recurrence after neoadjuvant chemotherapy and mastectomy without radiation. J Clin Oncol 20:17–23

    Article  PubMed  CAS  Google Scholar 

  5. Canadian Association of Radiation Oncologists (1998) Breast radiotherapy after breast-conserving surgery. The Steering Committee on Clinical Practice Guidlines for the Care and Treatment of Breast Cancer. CMAJ 158 Suppl 3:35–42

    Google Scholar 

  6. Doyle T, Schultz DJ, Peters C, Harris E, Solin LJ (2001) Long-term results of local recurrence after breast conservation treatment for invasive breast cancer. Int J Radiat Oncol Biol Phys 51:74–80

    Article  PubMed  CAS  Google Scholar 

  7. EUSOMA (2000) Position Paper: The requirements of a specialist breast unit. Eur J Cancer 36:2288–2293

    Article  Google Scholar 

  8. Fentiman IS, Balkwill FR, Cuzick J, Hayward JL, Rubens RD (1987) A trial of human alpha interferon a an adjuvant agent in breast cancer after loco-regional recurrence. Eur J Surg Oncol 13:425–428

    PubMed  CAS  Google Scholar 

  9. Fisher ER, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N (2001) Fifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer 91(8 Suppl): 1679–1687

    Article  PubMed  CAS  Google Scholar 

  10. Fisher B, Dignam J, Wolmark N, Mamounas E, Costantino J, Poller W, Fisher ER, Wickerman DL, Deutsch M, Margolese R, Dimitrov N, Kavanah M (1998) Lumpectomy and radiation therapy for the treatment of intraductal breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol 16:441–452

    PubMed  CAS  Google Scholar 

  11. Fowble B, Solin LJ, Schultz DJ, Rubinstein J, Goodman RL (1990) Breast recurrence following conservative surgery and radiation: Patterns of failure, prognosis, and pathologic findinghs from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys 19:833–842

    Article  PubMed  CAS  Google Scholar 

  12. Gatzemeier W, Orecchia R, Gatti G, Intra M, Veronesi U (2001) Intraoperative Strahlentherapy (IORT) in der Behandlung des Mammakarzinoms-eine neue therapeutische Alternative im Rahmen der brusterhaltenden Therapie? Strahlenther Onkol 177:330–337

    Article  PubMed  CAS  Google Scholar 

  13. Haffty BG, Reiss M, Beinfield M, Fischer D, Ward B, McKhann C (1996) Ipsilateral breast tumor recurrence as a predictor of distant disease: implications for systemic therapy at the time of local relapse. J Clin Oncol 14:52–57

    PubMed  CAS  Google Scholar 

  14. Julien JP, Bijker N, Fentiman IS, Peterse JL, Delledonne V, Rouanet P, Avril A, Sylvester R, Mignolet F, Bartelink H, Van Dongen JA on behalf of the EORTC Breast Cancer Cooperative Group and EORTC Radiotherapy Group (2000) Radiotherapie in breast-conserving treatment for ductal carcinoma in situ: first results of the EORTC randomised phase III trial 10853. Lancet 355:528–533

    Article  PubMed  CAS  Google Scholar 

  15. Kurtz JM, Jaquemier J, Amalric R, Brandone H, Ayme Y, Hans D, Bressac C, Spitalier JM (1991) Is breast conservation after local recurrence feasible? Eur J Cancer 27:240–244

    Article  PubMed  CAS  Google Scholar 

  16. Mamounas EP (2001) Ipsilateral breast tumor recurrence after lumpectomy: is it time to take the bull by the horns? J Clin Oncol 19:3798–3800

    PubMed  CAS  Google Scholar 

  17. Marret H, Perrotin F, Bougnoux P, Descamps P, Hubert B, Lefranc T, Le Floch O, Lansac J, Body G (2001) Low body mass index is an independent predictive factor of local recurrence after conservative treatment for breast cancer. Breast Cancer Res Treat 66:17–23

    Article  PubMed  CAS  Google Scholar 

  18. McCormick B, Halberg F, Peschel R, Phillips T, Son Y (1990) Breast Cancer. In: Interstitial Collaborative Working Group: Interstitial Brachytherapy, 221–226, Raven Press, New York

    Google Scholar 

  19. Mullen EE, Deutsch M, Bloomer WD (1997) Salvage radiotherapy for local failures of lumpectomy and breast irradiation, Radiother Oncol 42:25–29

    Article  PubMed  CAS  Google Scholar 

  20. Olson CE, Ansfield FJ, Richards MJ, Ramirez G, Davis HL (1977) Review of local soft tissue recurrence of breast cancer irradiated with and without actinomycin-D. Cancer 39:1981–1983

    Article  PubMed  CAS  Google Scholar 

  21. Petrovich Z, Langholz B, Lam K, Luxton G, Cohen D, Jepson J, Astrahan M (1989) Interstitial microwave hyperthermia combine with Iridium-192 radiotherapy for recurrent tumors. Am J Clin Oncol 12:264–268

    Article  PubMed  CAS  Google Scholar 

  22. Recht A, Silen W, Schnitt SJ, Connolly JL, Gelman RS, Rose MA, Silver B, Harris JR (1988) Time-course of local recurrence foolowing conservative surgery and radiotherapy for early stage breast cancer. Int J Radiat Oncol Biol Phys 15:255–261

    Article  PubMed  CAS  Google Scholar 

  23. Recht A, Schmitt S, Connolly J, Rose MA, Silver B, Come S, Henderson IC, Slavin S, Harris J (1989) Prognosis following local or regional recurrence after conservative surgery and radiotherapy for early stage breast carcinoma. Int J Radiat Oncol Biol Phys 16:3–9

    Article  PubMed  CAS  Google Scholar 

  24. Rouzier R, Extra JM, Carton M, Falcou MC, Vincent-Salomon A, Fourquet A, Pouillart P, Bourstyn E (2001) Primary chemotherapy for operable breast cancer: incidence and prognostic significance of ipsilateral breast tumor recurrence after breast-conserving surgery. J Clin Oncol 19:3828–3835

    PubMed  CAS  Google Scholar 

  25. Salvadori B, Marubini E, Miceli R, Conti AR, Cusumano F, Andreola S, Zucali R, Veronesi U (1999) Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Br J Surg 86:84–87

    Article  PubMed  CAS  Google Scholar 

  26. Schnitt SJ, Connolly JL, Recht A, Silver B, Harris JR (1985) Breast relapse following primary radiation therapy for early breast cancer. II. Detection, pathologic features and prognostic significance. Int J Radiat Oncol Biol Phys 11:1277–1284

    Article  PubMed  CAS  Google Scholar 

  27. Silverstein MJ, Lagios MD, Martino S, Lewinsky BS, Craig PH, Beron PJ, Gamagami P, Waisman JR (1998) Outcome after invasive local recurrence in patients with ductal carcinoma in situ of the breast. J Clin Oncol 16:1367–1373

    PubMed  CAS  Google Scholar 

  28. Stotter AT, McNeese MD, Ames FC, Oswald MJ, Ellerbroek NA (1989) Predicting the rate and extent of locoregional failure after breast conservation therapy for early breast cancer. Cancer 64:2217–2225

    Article  PubMed  CAS  Google Scholar 

  29. Tunon-de-Lara C, de-Mascarel I, Mac-Grogan G, Stockle E, Jourdain O, Acharian V, Guegan C, Faucher A, Bussieres E, Trojani M, Bonichon F, Barreau B, Dilhuydy MH, Dilhuydy JM, Mauriac L, Durand M, Avril A (2001) Analysis of 676 cases of ductal carcinoma in situ of the breast from 1971 to 1995: diagnosis and treatment — the experience of one institute. Am J Clin Oncol 24:531–536

    Article  PubMed  CAS  Google Scholar 

  30. van Tienhoven G, Voogd AC, Peterse JL, Nielsen M, Andersen KW, Mignolet F, Sylvester R, Fentiman IS, van der Schueren E, van Zijl K, Blichert-Toft M, Bartelink H, van Dongen JA (1999) Prognosis after treatment for loco-regional recurrence after mastectomy or breast conserving therapy in two randomised trials (EORTC 10801 and DBCG-82TM). EORTC Breast Cancer Cooperative Group and the Danish Breast Cancer Cooperative Group. Eur J Cancer 35:32–38

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral-, Gefäß- und Thoraxchirurgie des Universitätsklinikums, Charité, Campus Mitte, Humboldt-Universität zu Berlin, Schumannstraße 20/21, 10117, Berlin, Germany

    Klaus-Jürgen Winzer

Authors
  1. Klaus-Jürgen Winzer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Winzer, KJ. (2002). Lokoregionales Rezidiv. In: Digitale Revolution in der Chirurgie. Deutsche Gesellschaft für Chirurgie, vol 2002. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55715-6_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55715-6_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-44330-8

  • Online ISBN: 978-3-642-55715-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation