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85

NCCN Guidelines for Patients

®

Breast Cancer - Early-Stage

(STAGES I AND II)

, Version 1.2016

8

Breast cancer recurrence

Treatment options

Treatment options are based in part on where the

recurrence is. A local recurrence is breast cancer that

returned within a breast or within the chest wall near

to where a breast is or was. A regional recurrence

includes breast cancer that returned in lymph nodes

near to the breast area. These lymph nodes include

those near your armpit (axillary lymph nodes), below

your collarbone (infraclavicular lymph nodes), above

your collarbone (supraclavicular lymph nodes), and

near to your breastbone (internal mammary nodes).

Treatment options for recurrences are explained next.

Doctors use the term “systemic” when talking about

a cancer treatment for the whole body. Systemic

treatment for breast cancer recurrences includes

chemotherapy, chemotherapy with HER2 inhibitors,

and endocrine therapy.

Chart 8.2

lists the treatment options for a local

recurrence based on your prior treatment. If you had

breast-conserving therapy, a total mastectomy is

advised. You may also have an axillary lymph node

dissection if not done before. Systemic treatment may

be part of your treatment, too.

If previously treated with mastectomy alone, you

may have surgery to remove the cancer. Afterward,

radiation therapy to the chest wall and the lymph

nodes around your collarbone is advised. Systemic

treatment may be added.

You may have had a mastectomy, axillary lymph

node dissection, and radiation therapy. In this case,

the cancer should be removed by surgery if possible.

Systemic treatment may be added.

Chart 8.3

lists the treatment options for a recurrence

in your lymph nodes. The cancer may have also

returned in or near a breast. Treatment options are

based on which lymph nodes have cancer.

If cancer is found in your axillary lymph nodes,

these lymph nodes should be removed if possible.

Radiation therapy is also advised. Radiation sites

include your chest wall, near your armpit (axilla), and

the lymph nodes around your collarbone. You may

receive systemic treatment, too.

Radiation therapy without surgery is advised for

the return of cancer in supraclavicular or internal

mammary nodes. For a supraclavicular recurrence,

radiation sites include your chest wall and lymph

nodes around the collarbone. For an internal

mammary recurrence, radiation sites include your

chest wall, internal mammary nodes, and nodes

around the collarbone. You may receive systemic

treatment, too.