- Mastectomy is the standard treatment for ipsilateral breast tumor recurrence (IBTR), but little is known about repeat lumpectomy in lieu of mastectomy.
- This study found that repeat lumpectomy alone for IBTR is associated with higher mortality than mastectomy.
- If the tumor is ≤1 cm, repeat lumpectomy plus radiotherapy (RT) is associated with no difference in mortality vs mastectomy.
Why this matters
- In women with breast cancer, repeat lumpectomy should not be considered for IBTR unless it is accompanied by RT and if the tumor size is ≤1 cm.
- Population-based retrospective cohort of 5098 patients with IBTR (1973-2013), 79.4% of whom underwent mastectomy and 20.6% who underwent repeat lumpectomy in the Surveillance, Epidemiology and End Results (SEER) database.
- Funding: Shenkang Center City Hospital.
- Repeat lumpectomy (vs mastectomy) for IBTR is associated with higher overall mortality (HR, 1.522; P<.001 and higher cancer-specific mortality p>
- Repeat lumpectomy plus RT (vs mastectomy) for IBTR is associated with no difference in overall mortality, but higher cancer-specific mortality (HR, 1.540; P=.032).
- In the subgroup with pathological tumor size of ≤1 cm, repeat lumpectomy plus RT (vs mastectomy) for IBTR is associated with no difference in overall mortality or cancer-specific mortality.
- Observational design.
- Those who received lumpectomy were older than those who received mastectomy.