Breast-conserving therapy for invasive carcinoma: diagnosis of local recurrence

The way in which local recurrence after breast conserving treatment for invasive carcinoma became apparent, is reported in 44 patients. All patients were followed by regular physical examination and annual mammography. In 36 patients first suspicion of local recurrence was heralded by clinical signs and symptoms, presented between two scheduled routine visits in 12 patients, and at the time of a routine visit in 14 patients. Routine physical examination by surgeon or radiotherapist revealed local recurrence in 10 patients. Local recurrence was detected only by mammography in eight patients. Mammography confirmed the clinical suspicion in seven patients. The remaining 23 patients with clinical overt recurrence showed no signs of recurrent tumour on the mammographs performed after first clinical suspicion. Fine needle aspiration (FNA) cytology confirmed the clinical suspicion in 35 of the 38 tested patients. In our experience, regular physical examination is the mainstay for the detection of local recurrence after breast conserving therapy. Mammography was of limited value but proved more valuable for the early detection of recurrent tumour outside the primary tumour area. Fine needle aspiration cytology is a helpful tool in confirming the diagnosis of local recurrence.