Recurrent locally advanced breast cancer: the treatment of chest wall disease with further chemotherapy.

Locally recurrent advanced breast cancer is associated with significant morbidity and one aim of treatment is to control chest wall disease. There are no published data on the efficacy of subsequent courses of chemotherapy in this setting. We reviewed the case notes of 22 patients who developed locally recurrent breast cancer despite having received previous surgery, radiotherapy and one prior course of chemotherapy for local disease. These patients were treated with further systemic chemotherapy in an attempt to palliate their symptoms and control recurrent disease. The overall objective response rate observed with chemotherapy was 26% and a further 45% had stabilization of disease during treatment. Time to progression of disease was longest with anthracycline-based regimens; this decreased with subsequent lines of treatment. Chemotherapy was a safe and effective treatment modality in the care of women with locally recurrent breast cancer. A prospective database will now be established to collect further information on this group of patients, including their quality of life.