Local Recurrence After Postmastetomy Irradiation IN Breast Cancer

Purpose: The purpose of this study was to investigate the failure patterns of chest wall recurrence after postmastectomy radiotherapy (RT) in the patients with locally advanced breast cancer and the outcome of re-irradiaton. Materials and Methods: From January 1978 to December 1996, 17 patients with pathology confirmed recurrent breast cancer were included in this study. The recurrent chest wall was treated with 4 or 6 MV photon through tangential field technique or 9 MeV electron beam through anterior or oblique portal, in a daily dose of 2 Gy, 5 days per week. Total dose ranged from 20 to 60 Gy with the average dose of 48 Gy. Results: The median survival time from chest wall recurrence was 16 mouths, ranged from 3 months to 3.5 years. There was 90% of recurrence occurred within 2 years after postmastectomy irradiation, and 71% recurrent site occurred in the previous RT field. Fourteen patients (82%) developed distant metastases. Lung was the most common site. Conclusion: Re-irradiation to the chest wall played only a palliative role. Further systemic management should be investigated and recommended due to high incidence of distant metastases.