[Local forms of the treatment of recurrent breast cancer]

Recurrent breast cancer was classified into the following three groups; I: local skin (chest wall) recurrence including regional lymph nodes (61 cases), II: distant metastasis (93 cases), and III: local plus distant metastasis (33 cases). In this study, the results and evaluation of local forms of treatment for these recurrent breast cancers were analysed. Radiation therapy and surgical resection were mainly used for 61 patients with local recurrence at the primary site (32 skin, 24 lymph node and 5 skin plus lymph node). In most cases, however, various systemic treatments were combined or given consecutively. Response rate to radiation was high. The five-year survival rate after therapy for recurrence was 17% for radiation, 24% for resection with or without combination therapy and 14% for combined or other treatments. Surgical resection produced more long-term surviving patients. The solitary large nodule type of skin recurrence showed better prognosis than multiple small nodules or the diffusely infiltrating type. Recently, wide excision of the anterior breast wall with reconstruction has been performed and this contributes to improving the quality of life and survival. In addition, it is important that local treatment for recurrent breast cancer should be conducted along with a multidisciplinary approach using systemic combination therapy.