Chest Wall Recurrence After Mastectomy for Breast Cancer

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Breast cancer cells, SEM
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A chest wall recurrence is breast cancer that returns after a mastectomy. A chest wall recurrence may involve skin, muscle, and fascia beneath the site of the original breast tumor, as well as lymph nodes. A chest wall recurrence may be classed as a locoregional recurrence, or it may be linked to distant metastasis.

It can be incredibly confusing to research chest wall recurrence. What statistics are right?

Why do the treatments seem to contradict each other? For the purposes of this article, we are talking about people who have had a mastectomy. If cancer recurs in the breast after a lumpectomy, that is fairly different.


A chest wall recurrence may be first seen as a sore that doesn't heal, and possibly drains. There may be discomfort or a pulling sensation.


If your recurrence is visible, a biopsy may be done to determine whether it is a breast recurrence or not. If it is positive, oncologists recommend repeating tests to see if it is estrogen receptor positive, progesterone receptor positive, or HER2 positive. This may seem surprising after these were already tested, but in a recurrence, the receptor status of the cancer cells can change, especially if it has been more than a year or two since your mastectomy. In other words, if you originally had a breast cancer tumor that was estrogen receptor positive, your tumor cells may have changed and become estrogen receptor negative.

Since a locoregional recurrence such as a chest wall recurrence can be associated with distant metastases, a work-up for staging is often again done and may include a PET scan looking for other regions of spread in the body.


As with your original diagnosis of breast cancer, treatment of a recurrence usually combines a few treatments.

Chemotherapy: Chemotherapy is often used since systemic treatment is usually a goal. In other words, treatment that will attack cancer cells anywhere in the body, not just where your recurrence is located.

Surgery: Surgery may be done to remove the area of your chest wall that is affected. Depending on the depth and extent of your recurrence this may include using a flap to replace the area removed, or possibly placing a mesh to correct the defect after surgery removes the affected area.

Radiation therapy: Radiation therapy may be used, and will depend on whether you had radiation therapy after you were first treated for breast cancer.

Hormonal therapy and Targeted therapy: Treatments may depend on the status of receptors checked on your re-biopsy.

Photodynamic therapy: Studies have been done which suggest photodynamic therapy may be an effective way to treat some people with a chest wall recurrence.


Results are quite varied as to the prognosis after a locoregional breast cancer recurrence. It has been thought that having a chest wall recurrence is a poor prognostic sign, but some studies show very good 5-year disease-free survival. It's estimated that roughly 1 in 5 women who have a chest wall recurrence also have distant metastases, so in this case, prognosis would be as seen for people with stage 4 (metastatic) breast cancer.


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