Current Treatment of Isolated Locoregional Breast Cancer Recurrences

Abstract

Patients with isolated locoregional breast cancer recurrences should be treated with curative intent. Mastectomy is regarded as the standard of care for patients with ipsilateral breast tumor recurrence. In a selected group of patients, partial breast irradiation after second breast-conserving surgery is a viable alternative to mastectomy. If a second breast conservation is performed, additional irradiation should be mandatory, especially in patients who had not been irradiated previously. In case of re-irradiation, the largest experience exists for multi-catheter brachytherapy. Prospective clinical trials are needed to clearly define selection criteria, long-term local control, and toxicity. In patients with resectable locoregional breast cancer recurrences after mastectomy, multi-modal therapy comprising complete resection, radiation therapy in previously unirradiated patients, and systemic therapy results in 5-year disease-free and overall survival rates of 69% and 88%, respectively. In radiation-naive patients with unresectable, isolated locoregional recurrences, radiation therapy is mandatory. In selected patients with previous irradiations and unresectable locoregional recurrences, a second irradiation as part of an individual treatment concept can be applied. The increased risk of severe toxicity should always be weighed up against the potential clinical benefit. A combination therapy with hyperthermia can further improve the treatment results.

Neem leaf glycoprotein prevents post-surgical sarcoma recurrence in Swiss mice by differentially regulating cytotoxic T and myeloid-derived suppressor cells

“…However, post-surgical tumor recurrence in the primary site or in a distant site is a real fact after treatment completion or following a subsequent tumor-free period [ 2 – 4 ]. As recurrence after surgery remains a major cause of morbidity and mortality [ 5 , 6 ], this problem has been addressed by various approaches with a major goal to know the time and location of recurrence, survival of patients with recurrence and to design a treatment modality to prevent tumor recurrence with the ultimate aim to increase patients’ survival [ 7 – 12 ].…”

Interstitial multicatheter HDR-brachytherapy as accelerated partial breast irradiation after second breast-conserving surgery for locally recurrent breast cancer

“…However, patients undergoing MT may suffer from impaired body self-image and reduced self-esteem, followed by emotional and physical distress negatively impacting quality of life and sexual performance [ 24 ]. Hence, breast preservation should always be considered and offered after careful evaluation and appropriate patient selection [ 25 ]. However, second BCS alone is associated with a significantly higher rate of second IBTR compared with sMT [ 26 , 27 ], which is in turn associated with poor prognosis [ 7 , 28 ].…”

Reirradiation of recurrent breast cancer with proton beam therapy: A case report and literature review

“…Concerning the management of locoregional BC recurrence, the treatment is not standardized and demands a multidisciplinary approach[1,16,17]. The German Society of Radiation Oncology updated the radiotherapeutic guidelines and considered RT ( e.g ., external beam RT, brachytherapy, or intraoperative RT) as an essential part of multimodality treatment in addition to systemic therapy, surgery and hyperthermia[18].…”