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Purpose <p>This study investigated patterns of care and oncological outcomes in patients with ipsilateral breast tumor events (IBTE) after prior breast-conserving surgery (BCS) treated with curative intent.</p> Methods <p>A retrospective cohort study was conducted on IBTE patients treated in 2016–2017 at 34 Dutch hospitals. Patient and characteristics, along with treatment details were collected and descriptive statistics were used for analysis. Overall survival (OS), disease-free survival (DFS) and breast cancer-specific survival (BCSS) were evaluated by using Kaplan-Meier analyses.</p> Results <p>Of the 486 IBTE patients, 75.1% were diagnosed more than 5 years after the primary tumor, 87.4% had invasive breast cancer, and 12.6% DCIS. Distinguishing true recurrences from second primaries was not possible. Among invasive IBTE, 70 (14.6%) had primary DCIS and 350 (72.8%) an invasive primary tumor. Most IBTEs (54.9%) were T1, grade II (46.5%), and ER/PR+/HER2− (61.7%). Seventy-two (14.8%) patients received neoadjuvant systemic therapy. Salvage mastectomy was performed in 435 (89.5%) patients, while 51 (10.5%) underwent repeat BCS; 60.8% of these received postoperative whole-breast re-irradiation. Among mastectomy patients, 411 (94.5%) had prior radiotherapy; 13.1% received repeat radiotherapy, either alone (24.1%) or with hyperthermia (75.9%). Adjuvant systemic therapy was administered to 64.9%. After a median follow-up of 37 months, 83 (17.4%) developed a subsequent event: 33 (39.8%) second IBTE, 9 regional recurrences, and 41 (49.4%) distant metastases. Three- and five-year OS was 89% and 72.5%, respectively. Three- and five-year DFS was 85.5% and 69.9%, respectively. Three- and five-year BCSS was 95.1% and 86%, respectively.</p> Conclusions <p>Salvage mastectomy was the predominant treatment for IBTE, although repeat BCS with re-irradiation is increasingly performed in selected low-risk patients. Survival outcomes were favorable. The study highlights the need for tumor re-assessment and emphasizes the variability in IBTE management, underscoring the need for standardized treatment guidelines.</p>

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Patterns of Care and Follow-up of Patients with an Ipsilateral Breast Tumor Event After Breast-Conserving Surgery: A Multicenter Retrospective Cohort Study in the Netherlands

  • 期刊论文

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  • 发表日期：

    2026年7月17日

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  • Lisca F. Wurfbain,
  • Laura M. Tiels,
  • Maurice J. C. van der Sangen,
  • Coco J. E. F. Walstra,
  • Marissa C. van Maaren,
  • Birgit E. P. J. Vriens,
  • C. Willemien. Menke-van der Houven van Oordt,
  • Johanne G. Bloemen,
  • Adri C. Voogd,
  • Grard A. P. Nieuwenhuijzen,
  • Desirée H. J. G. van den Bongard,
  • Robert-Jan Schipper,
  • A. M. Zeillemaker,
  • E. J. T. Luiten,
  • S. van der Velden,
  • A. Doeksen,
  • T. T. Frakking,
  • S. Jeuriens,
  • H. A. P. Brokx,
  • L. de Widt,
  • P. Jansen,
  • B. M. D. Lemaire,
  • L. B. Koppert,
  • T. M. A. L. Klem,
  • W. Truin,
  • A. van Beurden,
  • J. Merkus,
  • W. J. Vles,
  • G. J. Liefers,
  • A. J. Maaskant-Braat,
  • M. Straver,
  • A. E. Dassen,
  • G. A. Gooiker,
  • M. S. Schlooz-Vries,
  • J. E. Rutter,
  • A. C. Brink,
  • L. H. Smit,
  • F. Aarts,
  • S. Brookman,
  • S. Muller,
  • W. de Roos,
  • D. J. Evers,
  • E. van Dessel,
  • J. van Bastelaar,
  • L. Outmani,
  • E. L. Postma,
  • C. A. Bargon,
  • S.den Besten,
  • H. Peters,
  • L. Daniels,
  • N. Verheuvel,
  • E. C. M. Zeestraten,
  • A. M. T. J. Raben,
  • J. C. van de Wetering,
  • S. C. Hagenaars,
  • L. M. van Roosendaal. L. Cornelissen,
  • S. Stokmans,
  • E. van Bergen,
  • R. P. G.ten Broek,
  • D. J. P. van Uden,
  • S. Schreurs,
  • S. F. Hardon,
  • R. R. Dulfer,
  • L. de Rooij

摘要

Purpose

This study investigated patterns of care and oncological outcomes in patients with ipsilateral breast tumor events (IBTE) after prior breast-conserving surgery (BCS) treated with curative intent.

Methods

A retrospective cohort study was conducted on IBTE patients treated in 2016–2017 at 34 Dutch hospitals. Patient and characteristics, along with treatment details were collected and descriptive statistics were used for analysis. Overall survival (OS), disease-free survival (DFS) and breast cancer-specific survival (BCSS) were evaluated by using Kaplan-Meier analyses.

Results

Of the 486 IBTE patients, 75.1% were diagnosed more than 5 years after the primary tumor, 87.4% had invasive breast cancer, and 12.6% DCIS. Distinguishing true recurrences from second primaries was not possible. Among invasive IBTE, 70 (14.6%) had primary DCIS and 350 (72.8%) an invasive primary tumor. Most IBTEs (54.9%) were T1, grade II (46.5%), and ER/PR+/HER2− (61.7%). Seventy-two (14.8%) patients received neoadjuvant systemic therapy. Salvage mastectomy was performed in 435 (89.5%) patients, while 51 (10.5%) underwent repeat BCS; 60.8% of these received postoperative whole-breast re-irradiation. Among mastectomy patients, 411 (94.5%) had prior radiotherapy; 13.1% received repeat radiotherapy, either alone (24.1%) or with hyperthermia (75.9%). Adjuvant systemic therapy was administered to 64.9%. After a median follow-up of 37 months, 83 (17.4%) developed a subsequent event: 33 (39.8%) second IBTE, 9 regional recurrences, and 41 (49.4%) distant metastases. Three- and five-year OS was 89% and 72.5%, respectively. Three- and five-year DFS was 85.5% and 69.9%, respectively. Three- and five-year BCSS was 95.1% and 86%, respectively.

Conclusions

Salvage mastectomy was the predominant treatment for IBTE, although repeat BCS with re-irradiation is increasingly performed in selected low-risk patients. Survival outcomes were favorable. The study highlights the need for tumor re-assessment and emphasizes the variability in IBTE management, underscoring the need for standardized treatment guidelines.