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. 2015 Mar;65(3):113-8.
doi: 10.1111/pin.12253. Epub 2015 Jan 20.

Four types of ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery: classification of IBTR based on precise pathological examination

Takehiko Sakai  1 , Seiichiro Nishimura, Akiko Ogiya, Masahiko Tanabe, Kiyomi Kimura, Hidetomo Morizono, Kotaro Iijima, Yumi Miyagi, Masujiro Makita, Yoshinori Ito, Masahiko Oguchi, Rie Horii, Futoshi Akiyama, Takuji Iwase
Affiliations

Four types of ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery: classification of IBTR based on precise pathological examination

Takehiko Sakai et al. Pathol Int. 2015 Mar.

Abstract

We classified ipsilateral breast tumor recurrences (IBTRs) based on strict pathological rules. Ninety-six women who were surgically treated for IBTR were included. IBTRs were classified according to their origins and were distinguished based on strict pathological rules: relationship between the IBTR and the primary lumpectomy scar, surgical margin status of the primary cancer, and the presence of in situ lesions of IBTR. The prognosis of these subgroups were compared to that of new primary tumors (NP) in the narrow sense (NPn) that occurred far from the scar. Distant-disease free survival of IBTR that occurred close to the scar with in situ lesions and a negative surgical margin of the primary cancer (NP occurred close to the scar, NPcs) was similar to that of NPn. In contrast, IBTR that occurred close to the scar without in situ lesions (true recurrence (TR) that arose from residual invasive carcinoma foci, TRinv) had significantly poorer prognosis than NPn. IBTR that occurred close to the scar with in situ lesions and a positive surgical margin of the primary cancer (TR arising from a residual in situ lesion, TRis) had more late recurrences than NPcs. Precise pathological examinations indicated four distinct IBTR subtypes with different characteristics.

Keywords: breast cancer; breast-conserving surgery; ipsilateral breast tumor recurrence; new primary tumor; true recurrence.

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