Recurrent breast cancer: factors influencing survival, including treatment.

Factors influencing survival were reviewed in 464 patients with recurrent breast cancer. Site of first recurrence and rate of tumor progression governed prognosis more than choice of initial therapy. Overall median survival was 22--26 months for bone/soft-tissue disease, 10--12 months for pleura/lung, and 4--6 months for liver/brain recurrence. Patients with slow rates of tumor progression at each site had longer survival terms than did rapid progressors. About 50% of patients with bone or soft-tissue recurrence had slow progression and long survival, regardless of whether initial treatment was local or systemic. In visceral recurrence, the number of patients with slow progression was doubled with systemic therapy in comparison to local treatment (from 16--20% for the latter to 37--38% for the former). In addition, long-term survival in patients with similar progression rates was best using initial systemic therapy.