Systemic Therapy in Local Recurrence of Breast Cancer, Report of a Case and Decision Making in MDT Meeting

Background: Locoregional recurrence of breast cancer has significantlydecreased over the last decades, particularly due to effective systemic therapy.While there is little controversy regarding local management of locoregionalrecurrences, in light of previous systemic treatment, additional chemotherapyregimens and their benefit to the patient are still subject to debate in tumors boards. Case Presentation: A ۴۵-year-old woman was referred to our tertiary carecenter with a local recurrence of breast cancer ۹ years after modified radicalmastectomy for a ypT۲N۲a invasive ductal carcinoma. She received neoadjuvanttreatment consisting of FEC-D (۵-FU-epirubicin-cyclophosphamide, followed bydocetaxel) for hormone receptor positive, HER-۲-neu negative cancer in ۲۰۰۹, aswell as adjuvant radiotherapy and tamoxifen for ۹ years. After R۰ resection of thehormone receptor positive, HER-۲-neu negative recurrence in ۲۰۱۹, adjuvanttherapy with ovarian suppression and an aromatase inhibitor was undertaken. Amultigene assay identified a recurrence score at ۳۷ and benefit from chemotherapy> ۱۵%. Question: What would the ideal chemotherapy regimen consist of for thispatient with an R۰ resection of late recurrence of breast cancer? Conclusion: After reviewing history, imaging and pathology, members of themultidisciplinary team recommended treatment with Taxotere andcyclophosphamide (TC) x ۴ for our patient.