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Oncology (Williston Park). 2000 Nov;14(11):1561-81; discussion 1581-2, 1582-4.

Local recurrence after mastectomy or breast-conserving surgery and radiation.

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  • 1Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.


Approximately 10% to 15% of patients with stage I/II invasive breast cancer will develop a clinically isolated local recurrence. The standard management of an ipsilateral breast tumor recurrence following breast-conserving surgery and radiation is salvage mastectomy, while local excision and radiation are optimal treatment of a chest wall recurrence following initial mastectomy. Although there are few data regarding the efficacy of systemic therapy after isolated local relapse, chemotherapy and/or hormonal therapy should be considered for most patients because of the high risk of subsequent distant relapse. However, local relapse does not always herald distant metastases. A prolonged interval between initial treatment and local recurrence is the most important prognostic factor for subsequent outcome, and when combined with other favorable characteristics, can predict 5-year survival rates of 70% or higher.

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