Radiotherapy is more effective than chemotherapy in local relapse of breast cancer. But surgical treatment, mastectomy, is the best therapy. Radiotherapy toxicity is of concern in locally recurrent breast cancer treatment.
Transcript of video
Locally recurrent breast cancer treatment options. 30% of breast cancer patients develop local breast cancer recurrence. Patients develop regional breast cancer recurrence. Radiotherapy to treat recurrent breast cancer is more effective than chemotherapy. Patients have local recurrence of breast cancer after previous radiation to the chest wall. Locally recurrent breast cancer can be treated by careful use of radiotherapy. Breast-sparing therapy was used before breast cancer local recurrence. Hypofractionated small volume radiotherapy can be an option. Chest wall radiation therapy needs to be offered as an additional treatment for recurrent breast cancer. Superficial hyperthermia with a modest dose of hypo-fractionated ionizing radiotherapy. Local control of breast cancer recurrence is excellent, above 90%. Radiation therapy treatment options. Advanced breast cancer treatment by targeted radiation therapy. Medical second opinion confirms radiotherapy breast cancer treatment plan. Medical second opinion helps to include best radiotherapy and combination breast cancer therapy into comprehensive personalized treatment plan. Best precision medicine radiation therapy treatment for advanced stage breast cancer with metastatic lesions. Get second opinion on advanced breast cancer diagnosis and be confident that your precision medicine treatment is the best. Video interview with top oncologist in radiation therapy treatment from Zurich, Switzerland. Locally recurrent breast cancer treatment options. Dr. Anton Titov, MD. Let’s move to breast cancer treatment. 30% of breast cancer patients develop local breast cancer recurrence. They can develop regional breast cancer recurrence. This is called locoregional recurring breast cancer. In these patients breast cancer returns. Local recurrence of breast cancer is a particular issue sometimes after the breast-sparing surgery. You used several innovative radiation therapy strategies in the recurring breast cancer. Sometimes breast cancer tumors come back locally or regionally in the chest wall. How effective is radiation therapy for recurrent breast cancer? Especially in locoregional recurrence of breast cancer. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). I think radiotherapy to treat recurrent breast cancer is much more effective than we previously thought. Radiation therapy for relapse in breast cancer is definitely more effective than chemotherapy. Chemotherapy has proven to be not based on evidence as a treatment for local recurrence of breast cancer. There are several settings in local recurrence of breast cancer. We have patients with breast conservative treatments. They have a breast cancer recurrence within the breast. These patients sometimes would like to preserve the breast. That’s one setting. We have breast cancer patients who had a breast-conserving treatment. They have a breast cancer recurrence. Sometimes these patients accept mastectomy. Then treatment of breast cancer is straightforward. We have patients who had mastectomy in a locally advanced breast cancer setting. These patients have local recurrence of breast cancer after previous radiation to the chest wall. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). For the setting number one the therapy is this. I think the standard practice still should be to convince the patient with breast cancer recurrence that mastectomy should be done. Cosmetic reconstruction after breast cancer surgery should be done according to the patient’s desires and to the recommendation of the breast cancer surgeon. Any cosmetic procedure to reconstruct the breast after mastectomy can be okay. This is established. It is accepted as evidence-based breast cancer treatment process. Sometimes patients with recurrent breast cancer do not accept a mastectomy followed by cosmetic surgery. Then hypofractionated small volume radiotherapy can be an option. But radiation therapy should only be done in a breast cancer clinical clinical trial treatment protocols. I don’t think hypo-fractionated small volume radiotherapy should be offered to patients with locally recurrent breast cancer. It is not a treatment option outside the clinical trial protocol. There are several adopted concepts for hypo-fractionated small volume radiotherapy in local recurrence of breast cancer. In Europe, we have two current protocols. They could be used as a basis for approach to treat local recurrent breast cancer by radiation therapy. I don’t speak about breast cancer patients who undergo breast conservative treatment initially. Then it is followed by radiotherapy. If these patients have local recurrence of breast cancer. Sometimes they accept mastectomy. That’s the definitive treatment of recurrent breast cancer. Only if you have a very bad prognostic features for recurrent breast cancer. Sometimes patient has bad local prognostic features of breast cancer. For example, R1 resection or other biological pathological features of breast cancer. Then chest wall radiation therapy needs to be offered as an additional treatment for recurrent breast cancer. I do speak now of the breast cancer patients who had mastectomy. Despite mastectomy, they have a chest wall recurrence. These patients had radiotherapy for the previous treatment of breast cancer. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). Then a full second course of radiotherapy is not acceptable. Toxicity is too high. Long-term toxicity to treat local recurrence of breast cancer is of concern. Toxicity includes necrosis to the ribs, serious infections of the chest wall. Toxicity includes long wound healing complications. Local recurrence of breast cancer and previous radiation therapy to the chest wall demands this therapy. The standard treatment should be superficial hyperthermia with a modest dose of hypo-fractionated ionizing radiotherapy. This is probably one of the best established methods to treat locally recurrent breast cancer. Sometimes previous therapy included radiation treatment. Meta-analysis of treatment results was done. It is the treatment of choice in some countries like the Netherlands. It is best therapy for recurrences of breast cancer. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). Over the last two and a half years we have successfully treated by radiotherapy with hyperthermia at least 30 consecutive patients with locally recurrent breast cancer. The local control of breast cancer recurrence is excellent, above 90%. Cosmetic outcome of recurrent breast cancer treatment by hyperthermia and hypo-fractionated radiotherapy is very good. It is according to the patient assessment. Dr. Anton Titov, MD. These are very good results of treatment of locally recurrent breast cancer, certainly. Locally recurrent breast cancer radiotherapy options. Radiation therapy is effective in local chest wall breast cancer relapse. Hyperthermia with radiotherapy.