[Therapy for recurrent breast cancer]

A multimodal treatment strategy for recurrent breast cancer is described. Occasionally, there are a few patients who have no other detectable distant metastases at the time of locoregional recurrence or of appearance of solitary lung metastasis. In such cases, curative results may be obtained with surgical treatment. In cases too extensive for surgical resection, irradiation is the treatment choice for local control. Radiotherapy is also helpful for painful bone lesions. The important basis for the multimodal approach to recurrent breast cancer is a well-balanced combination of local therapy with surgery or irradiation and systemic polychemoendocrine therapy or polychemotherapy followed by maintenance therapy, to improve the quality of life and survival of patients. Concerning the combined chemoendocrine therapy, many investigators have reported an improved effect with simultaneous or sequential use, but not all of these studies have confirmed the advantage of combination therapy over endocrine- or chemo-therapy alone, either in response rate or survival time. Further prospective randomized studies correlating ER status are needed to evaluate this approach. Immunotherapy used as a maintenance therapy may prolong the duration of remission and survival time.