title: 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.
authors.affiliation: Department of Radiation Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Harms
authors.affiliation: Department of Radiation Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Geretschläger
authors.affiliation: Department of Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Corinne
authors.initials: C
authors.lastname: Cescato
authors.affiliation: Department of Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Buess
authors.affiliation: Department of Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Dieter
authors.initials: D
authors.lastname: Köberle
authors.affiliation: Department of Radiation Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Branca
authors.initials: B
authors.lastname: Asadpour
keywords: Brachytherapy; Breast cancer; Chest wall recurrence; Hyperthermia; Ipsilateral breast tumor recurrence; Local recurrence breast; Locoregional recurrence breast cancer; Radiation therapy; Re-irradiation breast