Skip to main content
SpringerLink
Log in

Re-irradiation for Locally Recurrent Breast Cancer

  • Chapter
  • First Online:
Book cover Re-Irradiation: New Frontiers

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

Locally recurrent breast cancer occurs in 5–15 % of patients after breast conservation therapy and after mastectomy with adjuvant radiotherapy. Ipsilateral breast tumor recurrences may be salvaged with mastectomy; however, outcomes from repeat breast-conserving surgery and breast re-irradiation are promising. Chest wall recurrence generally portends a worse prognosis than in-breast local recurrences. A subset of patients may be long-term survivors in the absence of metastasis. Persistent chest wall disease can be symptomatic, and in previously irradiated patients, treatment options are limited. Experiences with chest wall re-irradiation have shown excellent response rates with acceptable late toxicity, but follow-up is limited.

The original version of this chapter was revised. An erratum to this chapter can be found at 10.1007/978-3-319-41825-4_78.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Abner AL, Recht A et al (1993) Prognosis following salvage mastectomy for recurrence in the breast after conservative surgery and radiation therapy for early-stage breast cancer. J Clin Oncol 11:44–48

    Article  CAS  PubMed  Google Scholar 

  • Alpert TE, Kuerer HM et al (2005) Ipsilateral breast tumor cancer recurrence after breast conservation therapy: outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation. Int J Radiat Oncol Biol Phys 63:845–851

    Google Scholar 

  • Arthur DW, Winter K et al (2015) NRG Oncology/RTOG 1014: 1-year toxicity report from a phase II study of repeat breast preserving surgery and 3D conformal partial-breast reirradiation (PBrI) for in-breast recurrence. Int J Radiat Oncol Biol Phys 93:S58–S59

    Article  Google Scholar 

  • Baglan KL, Sharpe MB et al (2003) Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT). Int J Radiat Oncol Biol Phys 55:302–311

    Article  PubMed  Google Scholar 

  • Bartelink H, Horiot JC et al (2001) Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345:1378–1387

    Article  CAS  PubMed  Google Scholar 

  • Beck TM, Hart NE et al (1983) Local or regionally recurrent carcinoma of the breast: results of therapy in 121 patients. J Clin Oncol 1:400–405

    Article  CAS  PubMed  Google Scholar 

  • Bedwinek JM, Lee J et al (1981) Prognostic indicators in patients with isolated local-regional recurrence of breast cancer. Cancer 47:2232–2235

    Article  CAS  PubMed  Google Scholar 

  • Bollet M, Servant N et al (2008) High-resolution mapping of DNA breakpoints to define true recurrences among ipsilateral breast cancers. J Natl Cancer Inst 100:48–58

    Article  CAS  PubMed  Google Scholar 

  • Buzdar AU, Blumenschein GR et al (1979) Adjuvant chemoimmunotherapy following regional therapy for isolated recurrences of breast cancer (stage IV NED). J Surg Oncol 12:27–40

    Article  CAS  PubMed  Google Scholar 

  • Cajucom CC, Tsangaris TN et al (1993) Results of salvage mastectomy for local recurrence after breast-conserving surgery without radiation therapy. Cancer 71:1774–1779

    Article  CAS  PubMed  Google Scholar 

  • Chadha M, Feldman S et al (2008) The feasibility of a second lumpectomy and breast brachytherapy for localized cancer in a breast previously treated with lumpectomy and radiation therapy for breast cancer. Brachytherapy 7:22–28

    Article  PubMed  Google Scholar 

  • Chu FC, Lin FJ et al (1976) Locally recurrent carcinoma of the breast. Results of radiation therapy. Cancer 37:2677–2681

    Article  CAS  PubMed  Google Scholar 

  • Dahlstrom KK, Andersson AP et al (1993) Wide local excision of recurrent breast cancer in the thoracic wall. Cancer 72:774–777

    Article  CAS  PubMed  Google Scholar 

  • Dalberg K, Mattsson A et al (1998) Outcome of treatment for ipsilateral breast tumor recurrence in early-stage breast cancer. Breast Cancer Res Treat 49:69–78

    Article  CAS  PubMed  Google Scholar 

  • Datta NR, Puric E et al (2016) Hyperthermia and radiation therapy in locoregional recurrent breast cancers: a systematic review and meta-analysis. Int J Radiat Oncol Biol Phys 94:1073–1087

    Article  PubMed  Google Scholar 

  • Deutsch M (2002) Repeat high-dose external beam irradiation for in-breast tumor recurrence after previous lumpectomy and whole breast irradiation. Int J Radiat Oncol Biol Phys 53:687–691

    Article  PubMed  Google Scholar 

  • Deutsch M, Parsons JA et al (1986) Radiation therapy for local-regional recurrent breast carcinoma. Int J Radiat Oncol Biol Phys 12:2061–2065

    Article  CAS  PubMed  Google Scholar 

  • Dragovic J, Seydel HG et al (1989) Local superficial hyperthermia in combination with low-dose radiation therapy for palliation of locally recurrent breast carcinoma. J Clin Oncol 7:30–35

    Article  CAS  PubMed  Google Scholar 

  • Fisher B, Anderson S et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241

    Article  PubMed  Google Scholar 

  • Formenti SC, Truong MT et al (2004) Prone accelerated partial breast irradiation after breast-conserving surgery: preliminary clinical results and dose-volume histogram analysis. Int J Radiat Oncol Biol Phys 60:493–504

    Article  PubMed  Google Scholar 

  • Fourquet A, Campana F et al (1989) Prognostic factors of breast recurrence in the conservative management of early breast cancer: a 25-year follow-up. Int J Radiat Oncol Biol Phys 17:719–725

    Article  CAS  PubMed  Google Scholar 

  • Ganz PA, Schag AC et al (1992) Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery? Cancer 69:1729–1738

    Article  CAS  PubMed  Google Scholar 

  • Gentilini O, Botteri E et al (2007) When can a second conservative approach be considered for ipsilateral breast tumour recurrence? Ann Oncol 18:468–472

    Article  CAS  PubMed  Google Scholar 

  • Guix B, Lejárcegui JA et al (2010) Exeresis and brachytherapy as salvage treatment for local recurrence after conservative treatment for breast cancer: results of a ten-year pilot study. Int J Radiat Oncol Biol Phys 78:804–810

    Article  PubMed  Google Scholar 

  • Halverson KJ, Perez CA et al (1990) Isolated local-regional recurrence of breast cancer following mastectomy: radiotherapeutic management. Int J Radiat Oncol Biol Phys 19:851–858

    Article  CAS  PubMed  Google Scholar 

  • Halverson KJ, Perez CA et al (1992) Survival following locoregional recurrence of breast cancer: univariate and multivariate analysis. Int J Radiat Oncol Biol Phys 23:285–291

    Article  CAS  PubMed  Google Scholar 

  • Hannoun-Levi JM, Houvenaeghel G et al (2004) Partial breast irradiation as second conservative treatment for local breast cancer recurrence. Int J Radiat Oncol Biol Phys 60:1385–1392

    Article  PubMed  Google Scholar 

  • Hannoun-Levi JM, Castelli J et al (2011) Second conservative treatment for ipsilateral breast cancer recurrence using high-dose rate interstitial brachytherapy: preliminary clinical results and evaluation of patient satisfaction. Brachytherapy 10:171–177

    Article  PubMed  Google Scholar 

  • Hannoun-Levi JM, Resch A et al (2013) Accelerated partial breast irradiation with interstitial brachytherapy as second conservative treatment for ipsilateral breast tumour recurrence: multicentric study of the GEC-ESTRO Breast Cancer Working Group. Radiother Oncol 108:226–231

    Article  PubMed  Google Scholar 

  • Harms W, Budach W et al (2016) DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences. Strahlenther Onkol 192:199–208

    Article  PubMed  PubMed Central  Google Scholar 

  • Huang E, Buchholz TA et al (2002) Classifying local disease recurrences after breast conservation therapy based on location and histology: new primary tumors have more favorable outcomes than true local disease recurrences. Cancer 95:2059–2067

    Article  PubMed  Google Scholar 

  • Huston TL, Simmons RM (2005) Locally recurrent breast cancer after conservation therapy. Am J Surg 189:229–235

    Article  PubMed  Google Scholar 

  • Ishitobi M, Komoike S (2011) Repeat lumpectomy for ipsilateral breast tumor recurrence after breast-conserving treatment. Oncology 81:381–386

    Article  PubMed  Google Scholar 

  • Ishitobi M, Okumura Y et al (2014) Repeat lumpectomy for ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery: the impact of radiotherapy on second IBTR. Breast Cancer Tokyo Jpn 21:754–760

    Article  Google Scholar 

  • Jones EL, Oleson JR et al (2005) Randomized trial of hyperthermia and radiation for superficial tumors. J Clin Oncol 23:3079–3085

    Article  PubMed  Google Scholar 

  • Kauer-Dorner D, Pötter R et al (2012) Partial breast irradiation for locally recurrent breast cancer within a second breast conserving treatment: Alternative to mastectomy? Results from a prospective trial. Radiother Oncol 102:96–101

    Article  PubMed  Google Scholar 

  • Kennedy MJ, Abeloff MD (1993) Management of locally recurrent breast cancer. Cancer 71:2395–2409

    Article  CAS  PubMed  Google Scholar 

  • Komoike Y, Motomura K et al (2003) Repeat lumpectomy for patients with ipsilateral breast tumor recurrence after breast-conserving surgery. Preliminary results. Oncology 64:1–6

    Article  PubMed  Google Scholar 

  • Kouloulias VE, Dardoufas CE et al (2002) Liposomal doxorubicin in conjunction with reirradiation and local hyperthermia treatment in recurrent breast cancer: a phase I/II trial. Clin Cancer Res 8:374–382

    CAS  PubMed  Google Scholar 

  • Kozak KR, Doppke KP et al (2006a) Dosimetric comparison of two different three-dimensional conformal external beam accelerated partial breast irradiation techniques. Int J Radiat Oncol Biol Phys 65:340–346

    Article  PubMed  Google Scholar 

  • Kozak KR, Katz A et al (2006b) Dosimetric comparison of proton and photon three-dimensional, conformal, external beam accelerated partial breast irradiation techniques. Int J Radiat Oncol Biol Phys 65:1572–1578

    Article  PubMed  Google Scholar 

  • Kraus-Tiefenbacher U, Bauer L et al (2007) Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapy. BMC Cancer 7:178

    Article  PubMed  PubMed Central  Google Scholar 

  • Kurtz JM, Amalric R et al (1988) Results of salvage surgery for mammary recurrence following breast-conserving therapy. Ann Surg 207:347–351

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kurtz JM, Spitalier JM et al (1990) The prognostic significance of late local recurrence after breast-conserving therapy. Int J Radiat Oncol Biol Phys 18:87–93

    Article  CAS  PubMed  Google Scholar 

  • Kurtz JM, Jacquemier J et al (1991) Is breast conservation after local recurrence feasible? Eur J Cancer 27:240–244

    Article  CAS  PubMed  Google Scholar 

  • Laramore GE, Griffin TW et al (1978) The use of electron beams in treating local recurrence of breast cancer in previously irradiated fields. Cancer 41:991–995

    Article  CAS  PubMed  Google Scholar 

  • Li G, Mitsumori M et al (2004) Local hyperthermia combined with external irradiation for regional recurrent breast carcinoma. Int J Clin Oncol 9:179–183

    Article  PubMed  Google Scholar 

  • Maulard C, Housset M et al (1995) Use of perioperative or split-course interstitial brachytherapy techniques for salvage irradiation of isolated local recurrences after conservative management of breast cancer. Am J Clin Oncol 18:348–352

    Article  CAS  PubMed  Google Scholar 

  • Maunsell E, Brisson J et al (1989) Psychological distress after initial treatment for breast cancer: a comparison of partial and total mastectomy. J Clin Epidemiol 42:765–771

    Article  CAS  PubMed  Google Scholar 

  • Nielsen HM, Overgaard M et al (2006) Study of failure pattern among high-risk breast cancer patients with or without postmastectomy radiotherapy in addition to adjuvant systemic therapy: long-term results from the Danish Breast Cancer Cooperative Group DBCG 82 b and c randomized studies. J Clin Oncol 24:2268–2275

    Article  PubMed  Google Scholar 

  • Oldenborg S, Van Os RM et al (2010) Elective re-irradiation and hyperthermia following resection of persistent locoregional recurrent breast cancer: a retrospective study. Int J Hyperthermia 26:136–144

    Article  PubMed  Google Scholar 

  • Osborne MP, Simmons RM (1994) Salvage surgery for recurrence after breast conservation. World J Surg 18:93–97

    Article  CAS  PubMed  Google Scholar 

  • Overgaard M, Hansen PS et al (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b trial. N Engl J Med 337:949–955

    Article  CAS  PubMed  Google Scholar 

  • Overgaard M, Jensen MB et al (1999) Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet 353:1641–1648

    Article  CAS  PubMed  Google Scholar 

  • Phromratanapongse P, Steeves RA et al (1991) Hyperthermia and irradiation for locally recurrent previously irradiated breast cancer. Strahlenther Onkol 167:93–97

    CAS  PubMed  Google Scholar 

  • Ragaz J, Olivotto IA et al (2005) Locoregional radiation therapy in patients with high-risk breast cancer receiving adjuvant chemotherapy: 20-year results of the British Columbia randomized trial. J Natl Cancer Inst 97:116–126

    Article  PubMed  Google Scholar 

  • Resch A, Fellner C et al (2002) Locally recurrent breast cancer: pulse dose rate brachytherapy for repeat irradiation following lumpectomy—a second chance to preserve the breast. Radiology 225:713–718

    Article  PubMed  Google Scholar 

  • Rowland JH, Desmond KA et al (2000) Role of breast reconstructive surgery in physical and emotional outcomes among breast cancer survivors. J Natl Cancer Inst 92:1422–1429

    Article  CAS  PubMed  Google Scholar 

  • Salvadori B, Marubini E et al (1999) Reoperation for locally recurrent breast cancer in patients previously treated with conservative surgery. Br J Surg 86:84–87

    Article  CAS  PubMed  Google Scholar 

  • Schwaibold F, Fowble BL et al (1991) The results of radiation therapy for isolated local regional recurrence after mastectomy. Int J Radiat Oncol Biol Phys 21:299–310

    Article  CAS  PubMed  Google Scholar 

  • Smith TE, Lee D et al (2000) True recurrence vs. new primary ipsilateral breast tumor relapse: an analysis of clinical and pathologic differences and their implications in natural history, prognoses, and therapeutic management. Int J Radiat Oncol Biol Phys 48:1281–1289

    Article  CAS  PubMed  Google Scholar 

  • Touboul E, Buffat L et al (1999) Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer. Int J Radiat Oncol Biol Phys 43:25–38

    Article  CAS  PubMed  Google Scholar 

  • Trombetta M, Julian TB et al (2009) Long-term cosmesis after lumpectomy and brachytherapy in the management of carcinoma of the previously irradiated breast. Am J Clin Oncol 32:314–318

    Article  PubMed  Google Scholar 

  • Trombetta M, Hall M et al (2014) Long-term follow-up of breast preservation by re-excision and balloon brachytherapy after ipsilateral breast tumor recurrence. Brachytherapy 13:488–492

    Article  PubMed  Google Scholar 

  • van der Zee J, van der Holt B et al (1999) Reirradiation combined with hyperthermia in recurrent breast cancer results in a worthwhile local palliation. Br J Cancer 79:483–490

    Article  PubMed  PubMed Central  Google Scholar 

  • Vernon CC, Hand JW et al (1996) Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: results from five randomized controlled trials. International Collaborative Hyperthermia Group. Int J Radiat Oncol Biol Phys 35:731–744

    Article  CAS  PubMed  Google Scholar 

  • Veronesi U, Cascinelli N et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232

    Article  PubMed  Google Scholar 

  • Vicini FA, Recht A et al (1992) Recurrence in the breast following conservative surgery and radiation therapy for early-stage breast cancer. J Natl Cancer Inst Monogr 11:33–39

    Google Scholar 

  • Voogd AC, van Tienhoven G et al (1999) Local recurrence after breast conservation therapy for early stage breast carcinoma: detection, treatment, and outcome in 266 patients. Dutch study group on local recurrence after breast conservation (BORST). Cancer 85:437–446

    Article  CAS  PubMed  Google Scholar 

  • Wagman R, Katz M et al (2002) Re-irradiation of the chest wall for recurrent breast cancer. Int J Radiat Oncol Biol Phys 54:237–238

    Article  Google Scholar 

  • Wahl AO, Rademaker A et al (2008) Multi-institutional review of repeat irradiation of chest wall and breast for recurrent breast cancer. Int J Radiat Oncol Biol Phys 70:477–484

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of Nebraska Medical Center, Buffett Cancer Center, 987521 Nebraska Medical, Omaha, NE, 68198-7521, USA

    Andrew O. Wahl MD

  2. Department of Radiation Oncology, Loyola University, Cardinal Bernardin Cancer Center, Maguire Center – Room 2944, 2160 S. 1st Ave., Maywood, IL, 60153, USA

    William Small Jr. MD

Authors
  1. Andrew O. Wahl MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William Small Jr. MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew O. Wahl MD .

Editor information

Editors and Affiliations

  1. Department of Oncology, University of Tromso and Nordland Hospital, Bodo, Norway

    Carsten Nieder

  2. University Medical Center Groningen, Groningen, The Netherlands

    Johannes Langendijk

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switerzland

About this chapter

Cite this chapter

Wahl, A.O., Small, W. (2016). Re-irradiation for Locally Recurrent Breast Cancer. In: Nieder, C., Langendijk, J. (eds) Re-Irradiation: New Frontiers. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2016_75

Download citation

  • DOI: https://doi.org/10.1007/174_2016_75

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41823-0

  • Online ISBN: 978-3-319-41825-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation