Breast Cancer Chest Wall Recurrence Management

  • Patients with chest wall recurrence:
    • Are at high risk for concurrent systemic recurrences:
      • Therefore, obtaining systemic staging and receptor information on the recurrence should be the first consideration
    • Often, there may be extensive local regional involvement in several areas along the chest wall and in the nodal regions
  • According to National Comprehensive Cancer Network guidelines:
    • Systemic staging generally consists of either a:
      • PET/ CT scan or a CT of the chest, abdomen, and pelvis, as well as a bone scan
  • Surgical excision with negative margins followed by comprehensive chest wall and nodal radiotherapy:
    • May be indicated in the absence of widespread systemic disease
  • This patient should be managed by a multidisciplinary team;
    • Including the surgeon, medical oncologists, radiologists, pathologists, and potentially a plastic surgeon
  • Patients may or may not benefit from chemotherapy:
    • In the CALOR trial:
      • Chemotherapy was found to benefit patients with resected ER negative isolated locoregional recurrence, but not ER positive isolated local regional recurrence
  • References
    • Wapnir I et al. JCO 4/10/18 vol 36 #11. P 1073-1079 Wapnir IL, Price KN, Anderson SJ, et al. Efficacy of chemotherapy for ER-negative and ER-positive isolated locoregional recurrence of breast cancer: final analysis of the CALOR Trial. J Clin Oncol. 2018;36(11):1973-1079.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s