EClinicalMedicine · 2026
Second ipsilateral locoregional recurrence in patients with hormone receptor-positive, HER2-negative breast cancer: a cohort study.
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Milano Monica, Valenza Carmine, Bianco Nadia, Manacorda Simona, Cavallone Matteo, Matera Letizia, Marsicano Renato Maria, Battaiotto Elena, Berton Giachetti Pier Paolo Maria, Giordano Edoardo, Etessami Julian David, Trapani Dario, Schena Simone, Sangalli Claudia, Kahler Ribeiro Fontana Sabrina, Gandini Sara, Veronesi Paolo, Galimberti Viviana, Colleoni Marco, Curigliano Giuseppe, Munzone Elisabetta
Аннотация
BACKGROUND: Evidence regarding outcomes in patients with hormone receptor (HR)-positive/HER2-negative breast cancer (BC) with a second consecutive ipsilateral locoregional recurrence (LRR) remains limited.
METHODS: Single-center, cohort study including consecutive patients with HR-positive/HER2-negative BC who underwent surgery (study baseline) for a second consecutive, ipsilateral LRR, at the European Institute of Oncology (Milan) from January 2001 to September 2025. Endpoints included invasive breast cancer-free survival (IBCFS) and distant recurrence-free survival (DRFS).
FINDINGS: 111 patients were included: median age at study baseline was 61 years. The second LRR occurred in the breast in 44% of patients, in locoregional lymph nodes in 23%, on the mastectomy scar or chest wall in 31%. Endocrine-resistant recurrence was observed in 69% of patients. Overall, 14% of patients received adjuvant chemotherapy and 5% a CDK4/6-inhibitor. At a median follow-up of 6.3 years (95% CI: 4.7-7.9), 57 IBCFS events and 40 DRFS events were reported. Median IBCFS was 6.8 years (95% CI: 4.8-7.6) and median DRFS was 9.6 years (95% CI: 6.9-Not Reached [NR]). Median IBCFS was longer in endocrine-sensitive compared to endocrine-resistant LRR (8.6 years [95% CI: 4.6-NR] vs. 5.3 years [95% CI: 4.0-6.9]), and in intraparenchymal LRR (6.8 years [95% CI: 4.8-NR]) compared to nodal (6.4 years [95% CI: 1.4-NR]) or chest wall (5.1 years [95% CI: 4.0-NR]) recurrence.
INTERPRETATION: Among patients experiencing a second consecutive LRR, approximately 50% develop a subsequent IBCFS event within 7 years, supporting consideration of treatment intensification, particularly in endocrine-resistant disease or recurrence involving the chest wall or regional lymph nodes.
FUNDING: None.
METHODS: Single-center, cohort study including consecutive patients with HR-positive/HER2-negative BC who underwent surgery (study baseline) for a second consecutive, ipsilateral LRR, at the European Institute of Oncology (Milan) from January 2001 to September 2025. Endpoints included invasive breast cancer-free survival (IBCFS) and distant recurrence-free survival (DRFS).
FINDINGS: 111 patients were included: median age at study baseline was 61 years. The second LRR occurred in the breast in 44% of patients, in locoregional lymph nodes in 23%, on the mastectomy scar or chest wall in 31%. Endocrine-resistant recurrence was observed in 69% of patients. Overall, 14% of patients received adjuvant chemotherapy and 5% a CDK4/6-inhibitor. At a median follow-up of 6.3 years (95% CI: 4.7-7.9), 57 IBCFS events and 40 DRFS events were reported. Median IBCFS was 6.8 years (95% CI: 4.8-7.6) and median DRFS was 9.6 years (95% CI: 6.9-Not Reached [NR]). Median IBCFS was longer in endocrine-sensitive compared to endocrine-resistant LRR (8.6 years [95% CI: 4.6-NR] vs. 5.3 years [95% CI: 4.0-6.9]), and in intraparenchymal LRR (6.8 years [95% CI: 4.8-NR]) compared to nodal (6.4 years [95% CI: 1.4-NR]) or chest wall (5.1 years [95% CI: 4.0-NR]) recurrence.
INTERPRETATION: Among patients experiencing a second consecutive LRR, approximately 50% develop a subsequent IBCFS event within 7 years, supporting consideration of treatment intensification, particularly in endocrine-resistant disease or recurrence involving the chest wall or regional lymph nodes.
FUNDING: None.