How to treat recurrent or metastatic breast cancer

All malignant tumors have the possibility of recurrence, and breast cancer is no exception. For breast cancer patients, incomplete surgical treatment, unreasonable radiotherapy, obesity, psychological factors and other factors may lead to recurrence. So, how should we deal with breast cancer recurrence?

Simple local recurrence

Patients with simple local recurrence after mastectomy should undergo local lesion resection according to their specific condition and cooperate with radiotherapy to the affected area (provided that there has been no radiotherapy in the past or that additional radiotherapy is safe). For patients with unresectable chest wall recurrence, if they have not had radiotherapy in the past, radiotherapy should be given.

For breast cancer patients with local recurrence after breast-conserving surgery, total mastectomy should be performed. After local treatment, chemotherapy or endocrine therapy should be considered as adjuvant treatment.

Patients with recurrent or advanced disease

For patients with recurrent, metastatic or advanced breast cancer, rescue treatment can be performed. Generally, rescue treatment can prolong the patient's survival and improve the quality of life, but it cannot cure cancer. Therefore, the treatment with the least toxicity should be given priority. For example, if the patient's condition meets the requirements, endocrine therapy will be better than cytotoxic therapy. For patients with ER-positive and/or PR-positive recurrent or metastatic breast cancer, endocrine therapy is suitable at the beginning. In addition, hormone receptor-negative or hormone receptor-positive patients who are resistant to endocrine therapy, if they only have bone or soft tissue or asymptomatic visceral metastases, can also consider participating in clinical studies of endocrine therapy.