Journal of Clinical Oncology, Vol 10, 474-483, Copyright © 1992 by American Society of Clinical Oncology
Identification of patients who are at high risk for locoregional breast cancer recurrence after conservative surgery and radiotherapy: a review article for surgeons, pathologists, and radiation and medical oncologists
DH Clarke and AA Martinez
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI.
PURPOSE: Many retrospective reports have been published identifying risk
factors for locoregional (LR) recurrence after breast conservation therapy
(BCT). We review these reports, with the purpose of better enabling
surgeons, pathologists, radiation oncologists, and medical oncologists to
develop strategies for an individualized treatment approach. DESIGN AND
RESULTS: English-language retrospective and prospective randomized studies
published in the 1980s were reviewed. Histopathologic predictors, young
age, extent of conservative surgery (CS), lobular carcinoma, and the impact
of adjuvant chemotherapy are all examined as reported risk factors for LR.
CONCLUSIONS: Recognition of these factors provides rationale for
individualizing the extent of CS based on histopathologic features. In
addition, the aggressiveness of radiotherapy (RT) should be dictated by the
extent of CS and by identifiable prognostic factors. Strategies are
presented for an individualized treatment approach based on a clear
understanding of the prognostic factors for LR.
