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Publications

Journal Article Epublish

PubMed: 42729525 DOI: 10.1016/j.eclinm.2026.104174

Second ipsilateral locoregional recurrence in patients with hormone receptor-positive, HER2-negative breast cancer: a cohort study.

EClinicalMedicine 99:104174

Authors: Monica Milano, Carmine Valenza, Nadia Bianco, Simona Manacorda, Matteo Cavallone, Letizia Matera, Renato Maria Marsicano, Elena Battaiotto, Pier Paolo Maria Berton Giachetti, Edoardo Giordano, Julian David Etessami, Dario Trapani, Simone Schena, Claudia Sangalli, Sabrina Kahler Ribeiro Fontana, Sara Gandini, Paolo Veronesi, Viviana Galimberti, Marco Colleoni, Giuseppe Curigliano, Elisabetta Munzone

Affiliations

  • Division of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy.
  • Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, IRCCS, Milan, Italy.
  • Department of Oncology and Hemato-Oncology (DIPO), University of Milan, Milan, Italy.
  • Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy.
  • Clinical Trial Office, European Institute of Oncology, IRCCS, Milan, Italy.
  • Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy.

Abstract

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.

MeSH

Lymph Nodes, Breast Neoplasms, Neoplasms, Cohort Studies, Hormones, Lymph, Breast