Surgical Treatment of Local Recurrence in Breast Cancer Patients

The surgical management of patients who develop a local recurrence requires a multidisciplinary approach and depends not only on the type of recurrence but also on factors related to the primary tumor treatment, taking into account first surgery and type of radiation therapy. For patients who develop a local recurrence after mastectomy, the surgical treatment consists of tumor resection obtaining clear margins or, in extensive diseases recurrence, coverage with skin grafts or autologous flaps. For patients who develop a local recurrence after a conservative surgery, the optimal surgical approach still remains controversial. Although international guidelines still recommend mastectomy for all local recurrences after primary breast-conservative surgery, several retrospective studies suggest that a new conserving procedure (including repeat lumpectomy and second sentinel node biopsy) may be technically and oncologically safe in selected patients.