SBRT as Salvage Re-Irradiation for Isolated In-Field Regional Relapse After Bilateral Breast Cancer – a Case Report

Abstract

"Stereotactic body radiation therapy (SBRT) is a type of radiotherapy which uses a high radiation dose delivered in a single or a few fractions and is employed with local curative intent for early-stage cancer, relapsed cancer or in the oligometastatic setting. The aim of this case report is to illustrate the potential of this technique in the salvage re-irradiation of a late isolated in field regional relapse after bilateral breast cancer. This is the case of a 65-years-old woman with a metachronous bilateral breast cancer (left side-1998, stage IIB, Luminal type; right side-2010, stage IIA, Her2 positive) who received both chemo- and endocrine systemic therapy, underwent surgery and was irradiated on both sides, with a late solitary recurrence in her left internal mammary node chain (2018) treated by SBRT re-irradiation (40 Gy in 5 fractions). Three years after salvage SBRT, under Palbociclib+Letrozole and thorough follow-up protocol, she is still in clinical complete remission, with a normal CA 15-3 and metabolically inactive residual mass on PET-CT, negative on a recent biopsy. SBRT is becoming a hallmark of oligometastatic disease management and can be invaluable in patients subjected to prior radiotherapy."