Hyperthermia in Locally Recurrent Breast Cancer

Abstract

Locally recurrent breast cancer poses a major therapeutic challenge, especially in a patient who has received prior radiotherapy and treatment options limited at the time of recurrence. Estimates of locoregional recurrence rates from large randomized trials range from 5 to 15 % of all patients with breast cancer treated with definitive intent postmastectomy or postlumpectomy radiotherapy [1–4]. Of the patients who recur, the ipsilateral breast or chest wall is the most common site of recurrence, representing up to 95 % of all locoregional recurrences [5–7]. Symptoms of a recurrent tumor in the chest wall can be devastating, with profound effects on quality of life. Such symptoms can include intractable pain, bleeding, infection, deformity, impaired breathing from lung invasion, and foul-smelling wounds requiring daily wound care. Isolated axillary or supraclavicular recurrences are observed less frequently than chest wall recurrences, ranging from 0.5 to 3.0 % [8, 9]; however, these patients also have a 50–65 % risk of developing distant metastatic disease [10, 11]. Given their location, however, axillary and supraclavicular recurrences tend to cause significant morbidity such as pain, lymphedema, impaired range of motion, and brachial plexopathy and may therefore require locoregional treatment despite the competing risk for distant metastases that will be treated with systemic therapy.