Recurrence of Breast Cancer : A Management Dilemma
There is always a word of advice on the management of early breast cancer, locally advanced breast cancer as well as metastatic breast cancer. Not much is spoken or written about Locally Recurrent breast cancer.
Recurrence is a unique case scenario where it is not possible to have clear-cut guidelines. Precise and personalized treatment is the need of the hour.
Mrs. N Sampat (name changed), a 55-year-old postmenopausal lady, diabetic and hypertensive presented with a 3 x 3 cms hard lump in her right breast.
Mammography was done & confirmed it to be a BIRADS V (malignant) lesion; also another 2 x 2 cms, BIRADS V lesion was also seen. FNAC confirmed it to be ductal carcinoma.
She underwent modified radical mastectomy (removal of the breast and axillary nodes). On her final histopathology report, she had hormone receptor-positive, multicentric Infiltrative ductal carcinoma of the breast with four positive nodes.
As an adjuvant treatment, she received 6 cycles of chemotherapy followed by radiation therapy over four weeks.
She had been taking Tab Letrozole for last 5 years. Now after a disease-free interval of 5 years, at the age of 60 years in April 2020, she noticed a swelling just below the clavicle.
Within three months this swelling rapidly increased to 7 x 7 cm. A pet scan showed it to be an isolated tumour recurrence site.
A core biopsy confirmed it to be hormone receptor-positive recurrent breast cancer. A local MRI was done, which showed involvement of Pectoralis major and Minor muscle, and tumour-causing compression of the axillary vein with 90-degree contact. The axillary artery and brachial plexus were free.
She was concerned about the inoperable and incurable status labelled to the disease by the local doctors.
On the scan, the tumor mass appeared to be operable with adequate margins. Wide excision of this lump was planned.
Wide excision of tumour mass with adequate margins was done and sent for final histopathology.
On histopathology, it was confirmed to be Recurrent Infiltrative ductal carcinoma with positive ER, and PR receptors. The patient is planned for further chemotherapy and hormonal therapy.
Clinical pictures are shown below:
It is possible to offer safe and curative treatment for recurrent breast cancer. Recurrence of breast cancer needs a patient-tailored treatment approach.
Also let’s look at another case study, where 30 year old lady who had multiple lumps in her breast & pain for more than 6 months. It was not cancer but treated successfully with surgery.
Let’s Fight Like A Girl!
Dr. Jay Rashmi Anam
Year Of Experience
Dr. Jay Anam is one of the best surgical oncologists & breast cancer specialist in Mumbai.
Dr. Jay Anam has Completed his M.Ch. Surgical Oncology training from Tata Memorial Centre. He did his Fellowship in Breast Oncology from Centre Oscar Lambret, Lille, France.
As a breast cancer specialist, he believes in world-class cancer care for all patients.
Let’s Fight Like A Girl!
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