Rationale for repeat breast-conserving surgery after in-breast recurrence of breast cancer

The main outcomes of our interest were local control and survival of 76 patients with local recurrence of breast cancer treated with conservative surgery (n = 32) or mastectomy (n = 44). There was not statistically significant difference in the probability of 5-years overall (81 %, 64.2 %; p = 0,245) and metastatic-free survival (60.7 %, 57.1 %, p = 0,553), as measured from the recurrence, and in rates of subsequent in-breast (12.5 %) or chest wall (11.4 %) recurrences between women of these two groups respectively. This fact is rationale for repeat breast-conserv- ing surgery in appropriately selected patients and requires further investigations

Optimization of indications for parasternal radiotherapy in patients with breast cancer

Detection of regional lymph nodes involvement is an extremely important step in the diagnosis and treatment of breast cancer. As with axillary lymph node metastases, parasternal lymph nodes metastases are an important prognostic factor. 1125 patients with breast cancer were under- went to thoracoscopicinternal mammary lymphadenectomy. Metastases were found in 204 of 1125 cases (18,3 %), representing 33,9 % of all cases of regional metastases (n = 601). Median overall survival in patients with internal mammary lymph nodes metastases who received radiation therapy and appropriate systemic treatment was 7,8 years, which is contrary to the earlier experience and is consistent with the results of the last years publications. We believe this excellent result is due to irradiation of the internal mammary nodes, and we believe that the thoracoscopic internal mammary lymphadenectomy should be a part of the diagnostic process in patients with breast cancer