If your breast cancer has come back and spread to the tissues and lymph nodes around the chest, neck and under the breastbone (locally advanced breast cancer, also called regional recurrence), treatment will depend on a number of factors. These include the location of the recurrence and any previous treatment you may have had.
Surgery and radiotherapy
If lymph nodes above or below the collarbone (clavicle), under the breastbone (sternum) or between the ribs are found to contain breast cancer, then surgical removal is not usually possible. In this situation radiotherapy may be offered.
If the recurrence has affected the muscles on the chest wall, then surgery may be offered as well as radiotherapy.
When recurrence has affected the skin of the breast, treatment will usually consist of systemic treatment. Local treatments such as surgery or radiotherapy may also be offered but this will depend on the amount of skin affected, its position and any previous radiotherapy treatment. Some people may be offered electrochemotherapy.
If the cancer is oestrogen receptor positive then you may be offered hormone therapy. If you were previously on hormone therapy when your cancer returned then your doctor may consider switching you to a different hormone drug.
You may also be offered chemotherapy. If you have previously had this treatment then different chemotherapy drugs may be used.
If your cancer is HER2 positive, you may be offered a targeted therapy like trastuzumab (Herceptin).