PURPOSES: The study evaluated prognostic factors for dissemination and survival in @entity1 with local or regional recurrence of @entity0 . Furthermore, the aim was to define subgroups of @entity1 at different risk of developing @entity3 in specific anatomical sites. @entity1 AND METHODS: The study included 140 @entity1 with isolated local or regional node recurrence, who entered a prospective study for staging of @entity1 with first recurrence of @entity0 in the period 1983-85. The primary treatment was a simple mastectomy; node positive @entity1 received adjuvant radiotherapy and chemotherapy or @entity440 . If possible, the locoregional recurrence was treated with surgery and/or radiotherapy, otherwise by systemic therapy. RESULTS: Median follow up was 10.4 years; 78 @entity1 developed distant @entity3 (soft tissue, 32%; bone, 45%; viscera 40%). Median time to dissemination was 4.4 years, and the ten year dissemination rate was 72%. Median time to dissemination was 3.7 years for @entity1 with recurrence in the regional nodes compared to 6.5 years for @entity1 with chest wall recurrence only, p = 0.05. No specific time sequence (temporal pattern) was observed in the anatomical distribution of @entity3 , and the anatomical site of recurrence could not be predicted by any of the prognostic factors. At follow up, 93 @entity1 had died. The median survival was 5.6 years and 30% were alive after 10 years. Forty-three of the 99 @entity1 who received local therapy only did not develop @entity3 . Fifteen of these @entity1 died without evidence of @entity3 while 28 @entity1 were still alive without distant recurrence after a median follow up time of 9.3 years (range, 6.5-11.9 years). Level of LDH and the number of positive regional nodes (NPOS) at primary diagnosis were significant independent prognostic factors for survival after recurrence. CONCLUSIONS: Approximately one third of the @entity1 receiving local treatment only, were alive and without distant @entity3 up to ten years after locoregional recurrence, indicating that there is a subset of @entity1 which may be long term survivors after local treatment only (surgery or radiotherapy). The duration of survival can be estimated by LDH and NPOS, but the model needs validation in a separate data set before clinical use.

Pattern of dissemination and survival following isolated locoregional recurrence of XXXX . A prospective study with more than 10 years of follow up.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity440 :: ('MESH:D013629', 'Chemical') :: ['tamoxifen'] @entity0 :: ('MESH:D001943', 'Disease') :: ['breast cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases', 'metastatic disease']
@entity0 :: (MESH:D001943,Disease) :: ['breast cancer']
