EDU 44 - Salvage Therapy for Local-Regional Breast Cancer Recurrence: What, When, and How Much?

Moderator(s)

• 

  Isabelle Choi, MD

  New York Proton Center
  New York, New York

Breast cancer recurrence after prior definitive multimodality treatment is an increasingly common clinical situation faced by practitioners, with long-term new primary or recurrent non-metastatic locoregional recurrence developing not infrequently over 10 years following initial treatment. Because primary therapy often involves radiotherapy, delivering reirradiation in the salvage setting has commonly been not considered, or, when delivered, has been approached with much hesitation and with heterogeneous treatment approaches due to concern for excess and serious adverse effects of a second course of radiotherapy to normal tissues. However, salvage radiotherapy is an important component of multidisciplinary management of non-metastatic breast cancer recurrence in order to achieve disease control to areas at high risk of further relapse. Recent data have emerged to better understand the implications and outcomes associated with reirradiation, and with this additional experience, more clarity on best practices in the delivery of reirradiation for breast cancer recurrence has been gained, including treatment modality/technique selection, treatment field and target volume delineation, and dose-fractionation regimens. Additionally, new data supporting the utilization of several novel systemic therapy agents have further advanced the overall treatment landscape for non-metastatic breast cancer recurrence. In this session, recent literature in reirradiation and systemic salvage agents will be discussed, and the current landscape in multimodality management of non-metastatic breast cancer will be presented, with a focus on treatment options, patient selection, and clinical considerations when delivering salvage therapies.

Presentations:

• 2:30 PM – 2:32 PM ET

  Introductions
  

  Speaker: Isabelle Choi, MD – New York Proton Center
• 2:32 PM – 2:50 PM ET

  Repeat Breast Conservation Therapy for In-Breast Recurrence: Rationale and Considerations
  

  Speaker: Danielle Rodin, MD – Princess Margaret Cancer Centre
• 2:50 PM – 3:08 PM ET

  Salvage Reirradiation for High-Risk Local-Regional Breast Cancer Recurrence: Field, Modality, and Dose Selection
  

  Speaker: Atif Khan, MD, MS – Memorial Sloan Kettering Cancer Center
• 3:08 PM – 3:26 PM ET

  Advances in Salvage Systemic Therapy Options for Breast Cancer Recurrence
  

  Speaker: Joseph Sparano, MD
• 3:26 PM – 3:45 PM ET

  Questions and Answers
  

  Speaker: Isabelle Choi, MD – New York Proton Center