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Recurrent breast cancer on the chest wall

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James M. Metz, MD
Last Modified: September 29, 2002

Dear OncoLink "Ask The Experts,"

Can you give me any information about breast cancer that has spread to the skin? I have recently been diagnosed with this recurrent disease after undergoing chemo and radiation plus mastectomy.

James M. Metz, MD, Editor-in-Chief of OncoLink and Assistant Professor of Radiation Oncology at the Hospital of the University of Pennsylvania, responds:

I assume you are talking about a local recurrence of breast cancer in the skin overlying the chest wall where the original tumor was located. It is very important a patient is aggressively evaluated when this occurs because there is a high risk of spread to distant parts of the body (metastases). One most decide if this is a local recurrence only versus a patient who also has distant metastatic disease. The work-up includes a CT scan of the chest and abdomen, bone scan, blood tests, and sometimes a head scan. If there is no evidence of metastatic disease, aggressive local treatment may still be attempted to cure the patient. A surgical resection may be attempted in selected circumstances. Also, hyperthermia treatments to the chest wall may be an option in some patients. There are clinical trials evaluating the use of photodynamic therapy to the skin of the chest wall depending on the thickness of the skin lesions. Many patients are treated with systemic therapy including hormonal therapy and chemotherapy due to the high risk of developing metastatic disease after a local recurrence.