Botros M et al. / Recurrent breast cancer and breast implant rupture 25 ranged from either superior, the same, or poorer.8 Although, most recent studies confirm that the prognosis of ILC is indeed similar to that of IDC.9- 12 Sastre-Garau et al. examined the difference in overall survival, incidence of local or distant recur- rence, disease free interval, rate of metastasis and pattern of metastatic distribution among patients who were diagnosed with ILC, ILC-IDC mixed his- tology, and non-ILC. They found that univariate and multivariate analysis did not reveal any statis- tically significant difference between these groups regarding overall survival, recurrence, disease free interval, or the frequency of metastasis. However, the pattern of distribution of metastases did differ among the groups. ILC patients were more likely to have disease disseminate to bone rather than the lungs or pleura as seen more often with IDC. ILC patients were also more likely to have distant disease in the peritoneum, gynecological tract, and gastrointestinal tract.10 This pattern of metastatic dissemination has also been reported in several previously published studies.10,13-15 Our patient did indeed become afflicted with this pattern of meta- static distribution as she had multiple bony metas- tases as well as peritoneal metastasis. According to the current consensus, treatment for ILC may include breast conservation surgery when surgical margins are adequate along with subsequent radiation therapy.7 A study published by Santiago et al. compared long-term outcomes for women who underwent breast conservation surgery for either early stage ILC or IDC and found the results be similar between the groups.16 Although due to difficulty in localization and mar- gin detection associated with this particular tumor, the rates of mastectomy in patients afflicted with ILC have been higher than that for IDC. However, treatment trends show that there is movement from aggressively treating ILC with mastectomy to breast conservation.17 If a tumor can be removed by lumpectomy with negative margins, then lumpec- tomy and radiation therapy is warranted.7 It is important to point out that our patient did not undergo post-mastectomy irradiation during treatment of her primary tumor. Studies that date as far back as the early 1970s have shown that the use of post-mastectomy adjuvant radiation de- creases the incidence of locoregional recurrence by two thirds.18 Two published studies have also shown that the use of adjuvant irradiation has a positive effect on survival rates, with the study by Overgaard, et al. showing a statistical significance in overall survival in high risk post-menopausal woman diagnosed with brest cancer.19, 20 FIGURE 1. Deflated right breast implant with associated recurrent cancer infiltrating the chest wall and thorax. FIGURE 2. Disease infiltrating the mediastinum from recurrent breast cancer. Radiol Oncol 2012; 46(1): 23-27.