Radiation therapy for local-regional recurrent breast carcinoma

One hundred seven women with recurrent breast carcinoma involving the chest wall and/or regional lymph node regions were treated with radiotherapy between 1970 and 1979. Local-regional tumor was the initial and only evidence of recurrent breast carcinoma in all cases. Forty-seven patients had their disease confined to the chest wall alone and sixty (56%) patients had chest wall involvement as some component of their local-regional recurrent disease. Within five years after the initial mastectomy, 80.5% of recurrences were manifested. All patients had radiotherapy to at least the site of involvement. Eighty-four patients (78.5%) had a complete response. The absolute 5-year survival of all patients following local-regional recurrence was 34.6%. Five year survival was 29% in those patients who had recurrence within 5 years of the original mastectomy. For those patients whose local-regional recurrence occurred after a 5-year disease-free interval, the subsequent 5-year survival was 57%. For patients with recurrence confined to the chest wall, subsequent 5-year survival was 48.9%. Patients who had supraclavicular involvement as part of their local-regional recurrence had only a 16.1% 5-year survival. The majority of patients developed distant metastasis. Twenty-two patients developed carcinoma of the contralateral breast following local-regional recurrence. Five year survival following local-regional recurrence was only 4.3% for patients whose initial treatment for their primary breast carcinoma was surgery and adjuvant chemotherapy. For those patients whose primary breast carcinoma was treated by surgery alone or surgery and post-operative radiotherapy, the 5-year survival following local-regional recurrence was over 40%.