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

Author(s) :

Tiberiu Popescu1, Angelica Chiorean2, 3, Noemi Schultes4, Catalin Iacob1, Dan Eniu5, 6

1 Department of Radiation Oncology, RTC Amethyst, Cluj, Romania

2 Department of Imaging and Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj, Romania

3 MedImages Clinic, Cluj, Romania

4 Department of Medical Physics, RTC Amethyst, Cluj, Romania

5 Department of Surgical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj, Romania

6 Department of Surgical Oncology, Prof. Dr. Ion Chiricuta Institute of Oncology, Cluj, Romania

Corresponding author: Tiberiu Popescu, Email:

Published: Volume I, Issue 2 (December 2021) 63-69, , , - DOI: 10.53011/JMRO.2021.02.07

Open Access

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December 27, 2021 0 Comments


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.

Fig.1: Timeline of disease and therapy
Fig. 2: Isodose lines and maximum dose point (Max), target volumes, and organs at risk
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