For locoregional recurrence of breast cancer, there is no standard of care because there are so few patients in whom this occurs.
The approach, therefore, needs to be individualized, said William Gradishar, MD, professor of medicine, Northwestern University, Evanston, IL.
"The biggest issue that we confront as medical oncologists is once we are aware of a patient who has a locoregional recurrence, more often than not, they have an earlier history of an earlier stage breast cancer, they've gotten some form of adjuvant therapy, and they could very well be many years down the line. Or in particularly aggressive disease, it could be in themidst of their ongoing anti-hormonal adjuvant therapy," said Dr. Gradishar.
"The decision we have to make once it's been diagnosed is whether there's a role for additional different adjuvant therapy," he added. "We have to decide, do all patients need the same type of therapy?"
Dr. Gradishar outlined the further risks in these patients, as well as the differences by cancer subtype in deciding what the optimal therapy should be for each patient.