Risk of Local Relapse in Lumpectomy Patients

Risk of Local Relapse (Recurrence in the Breast) After Lumpectomy

The risk of the tumor growing back in the breast is relatively small (but is higher in young women, women with DCIS, close margins, if the radiation is not given or if a boost is not included, see sections on boost field, margins #1 and margins #2) More recent studies show a lower risk of local relapse (see here) particularly if chemotherapy is used (see here.) See section on lumpectomy without radiation (here.)

Recurrences can show up as late as 5, 10 or even 15 years after the initial treatment, the risk in large collected series are:

Literature Review of 21 Series
Relapse by 5 Years	2 - 10%
Relapse by 10 Years	8 - 20%

The risk of a relapse is higher in younger women as noted:

Literature Review of 7 Series
Age	Relapse Rate
Women < 35 - 50	19%
Women age > 35-50y	8%


The risk is higher if the radiation is not given and lower if chemotherapy is also given (so even if chemotherapy is given after a lumpectomy, it is still necessary to radiare the breast afterwards or the local relapse is quite high (41%) as noted below:

Relapse Rate after Lumpectomy (NSABP B-06 Trial)
Therapy	No Chemo Given	Chemotherapy
No Radiation	32%	41%
Radiation Given	12%	5%

Patients given chemotherapy or tamoxifen (along with the radiation) have the lowest risk of local relapse as noted in the recent study from MD Anderson where only 4.4% relapsed by 8 years:

^{Local Control in Lumpectomy
Patients (MD Anderson Series of Node Negative)}
Interval	Radiation	Radiation + Chemo (Tamoxifen)
Local Control at 5 years	89.9%	97.5%
Local Control at 8 years	85.2%	95.6%