{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T12:56:11Z","timestamp":1761742571886,"version":"build-2065373602"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,6,20]],"date-time":"2005-06-20T00:00:00Z","timestamp":1119225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2005,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>In patients with breast carcinoma, ipsilateral breast tumor recurrence (IBTR) after breast\u2010conserving therapy (BCT) is an independent predictor of systemic recurrence and disease\u2010specific survival (DSS). However, only a subgroup of patients with IBTR develop systemic recurrences. Therefore, the management of isolated IBTR remains controversial. The objective of the current study was to identify determinants of systemic recurrence and DSS after IBTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The medical records of 120 women who underwent BCT for Stage 0\u2013III breast carcinoma between 1971 and 1996 and who subsequently developed isolated IBTR were reviewed. Clinicopathologic factors were studied using univariate and multivariate analyses for their association with DSS and the development of systemic recurrence after IBTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median time to IBTR was 59 months. At a median follow\u2010up of 80 months after IBTR, 45 patients (37.5%) had a systemic recurrence. Initial lymph node status was the strongest predictor of systemic recurrence according to the a univariate analysis (<jats:italic>P<\/jats:italic> = 0.001). Other significant factors included lymphovascular invasion (LVI) in the primary tumor, time to IBTR \u2264 48 months, clinical and pathologic IBTR tumor size &gt; 1 cm, LVI in the recurrent tumor, and skin involvement at IBTR. In a multivariate logistic regression analysis, initially positive lymph node status (relative risk [RR], 5.3; 95% confidence interval [95% CI], 1.4\u201320.1; <jats:italic>P<\/jats:italic> = 0.015) and skin involvement at IBTR (RR, 15.1; 95% CI, 1.5\u2013153.8; <jats:italic>P<\/jats:italic> = 0.022) remained independent predictors of systemic recurrence. The 5\u2010year and 10\u2010year DSS rates after IBTR were 78% and 68%, respectively. In a multivariate Cox proportional hazards model analysis, only LVI in the recurrent tumor was found to be an independent predictor of DSS (RR, 4.6; 95% CI, 1.5\u201314.1; <jats:italic>P<\/jats:italic> = 0.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients who initially had lymph node\u2010positive disease or skin involvement or LVI at IBTR represented especially high\u2010risk groups that warranted consideration for aggressive, systemic treatment and novel, targeted therapies after IBTR. Determinants of prognosis after IBTR should be taken into account when evaluating the need for further systemic therapy and designing risk\u2010stratified clinical trials. Cancer 2005. \u00a9 2005 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.21224","type":"journal-article","created":{"date-parts":[[2005,6,20]],"date-time":"2005-06-20T19:46:37Z","timestamp":1119296797000},"page":"479-490","source":"Crossref","is-referenced-by-count":40,"title":["Predictors of systemic recurrence and disease\u2010specific survival after ipsilateral breast tumor recurrence"],"prefix":"10.1002","volume":"104","author":[{"given":"Jeannie","family":"Shen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly K.","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadeem Q.","family":"Mirza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Buchholz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gildy V.","family":"Babiera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry M.","family":"Kuerer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Bedrosian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merrick I.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick C.","family":"Ames","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry W.","family":"Feig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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