Abstract • Pathologic and surgical aspects of 1,027 breast cancer cases treated between 1961 and 1972 were reviewed. Sixty-eight (7%) of the cases recurred locally. This low rate of recurrence is associated with the small average diameter of 2.7 cm of all carcinomas and the correspondingly low rate of axillary lymph node metastasis of 40%. Subsequently recurring tumors had a higher incidence of axillary lymph node metastasis (68%). Eight hundred eighty-eight infiltrating duct carcinomas represented the largest group of cases and had a recurrence rate of 5.7%. Comedo, infiltrating papillary, and infiltrating lobular carcinomas recurred locally more frequently, but none of 26 mucinous carcinomas recurred. In eight cases, the recurrent tumor was of a more malignant histologic type than the primary lesion. The average width of the excised segments of skin decreased from 9.8 cm during the first three-year period (1961 to 1963) to 8.4 cm during the last period (1970 to 1972). The average width for the entire period was 9.1 cm, identical for locally recurring and nonrecurring tumors. (Arch Surg 111:323-325, 1976) References 1. Auchincloss H Jr: The nature of local recurrence following radical mastectomy . Cancer 11:611-619, 1958.Crossref 2. Crile G Jr: Rationale for cutting thick skin flaps and not grafting skin in operations for cancer of the breast . Cancer 1:795-799, 1965.Crossref 3. Crile G Jr: Low incidence and morbidity of local recurrence after conservative operations for cancer of the breast . Ann Surg 175:249-253, 1972.Crossref 4. Dao TL, Nemoto T: The clinical significance of skin recurrence after radical mastectomy in women with cancer of the breast . Surg Gynecol Obstet 117:447-453, 1963. 5. Spratt JS Jr, Donegan WL: Local and regional recurrence , in: Cancer of the Breast . Philadelphia, WB Saunders Co, 1967, pp 190-200. 6. Donegan WL, Perez-Mesa CM, Watson FR: A biostatistical study of locally recurrent breast carcinoma . Surg Gynecol Obstet 122:529-540, 1966. 7. Haagensen CD: Diseases of the Breast , ed 2. Philadelphia, WB Saunders Co, 1971. 8. Zimmerman KW, Montague ED, Fletcher GH: Frequency, anatomical distribution and management of local recurrences after definitive therapy for breast cancer . Cancer 1:67-74, 1966.Crossref 9. Pawlias KT, Dockerty MB, Ellis FH Jr: Late local recurrent carcinoma of the breast . Ann Surg 148:192-198, 1958.Crossref 10. Conway H, Neumann CG: Evaluation of skin grafting in the technique of radical mastectomy in relation to local recurrence of carcinoma . Surg Gynecol Obstet 88:45-49, 1949. 11. Marshall KA, Redfern A, Cady B: Local recurrences of carcinoma of the breast . Surg Gynecol Obstet 139:406-408, 1974. 12. Bailey ME, Ratnavel K, Wyatt AP: The problem of local recurrence following conservative surgery for carcinoma of the breast . Br J Surg 60:957-958, 1973.Crossref 13. McDivitt RW, Stewart FW, Berg JW: Tumors of the Breast . Atlas of Tumor Pathology, Armed Forces Institute of Pathology, 1968, section 2 , (pt 2) . 14. Dixon WJ, Massey FJ Jr: Introduction to Statistical Analysis , ed 3. New York, McGraw-Hill Book Co Inc, 1969. 15. Kern WH, Mikkelsen WP: Small carcinomas of the breast . Cancer 28:948-955, 1971.Crossref 16. Crile G Jr, Schofield PF: Effect of lymphatic obstruction on the growth and metastasis of tumors . Surg Gynecol Obstet 128:1042-1046, 1969.
Archives of Surgery – American Medical Association
Published: Apr 1, 1976