Recurrent breast cancer may be in the area of the breast surgery or in the chest wall. 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.
Most patients with even small local recurrences, 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. These figures apply to patients who develop chest wall recurrence after aggressive surgery such as a modified radical mastectomy . The prognosis is much better if a recurrence occurs in the breast after conservative surgery followed by radiation therapy.
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, if it has been at least two years since
mastectomy and if hormone receptors are positive or unknown, the standard treatment is tamoxifen or removal
of the ovaries for premenopausal patients, and tamoxifen, estrogens , androgens , Cytadren or progestin
