Recurrent breast cancer may develop in the breast, the chest wall or local lymph nodes . Alternatively, it may be metastatic disease anywhere in the body.
A recurrence in the skin or chest wall near the surgical site most often indicates that more widespread metastatic disease will occur in the future, although it may be the only site of recurrence in a small group of patients. For these patients, local additional surgery and/or radiation therapy may be used. A recurrence in the breast after breast conservation may not be as serious and can often be dealt with by a further lumpectomy or by mastectomy.
Most patients with even small local recurrences after mastectomy, however, will eventually develop other areas of metastasis despite aggressive local treatment. After treatment of an isolated local recurrence, only 30 percent of patients have developed no other evidence of spread by 5 years, 7 percent by 10 years.
Standard Treatment
• If there is no internal disease and recurrence is confined to the area of the original tumor , surgery and/or
radiation therapy is used, plus tamoxifen in selected cases.
• If there is no life-threatening disease involving major internal organs and if hormone receptors are positive or
unknown, the standard treatment is tamoxifen or removal of the ovaries for premenopausal patients, and
tamoxifen, androgens , aminoglutethimide or progestin therapy for postmenopausal patients.
