[Locoregional recurrence in breast cancer--what should be done?]

Recurrence is a quite common problem in breast cancer. Strictly local recurrence seems to be not much different from an early breast cancer situation with minimal tumor load, and surgical removal may be adequate. If recurrence with multiple local tumors and/or regional nodes is present, most patients will develop metastatic disease. Treatment of loco-regional recurrence depends on prognostic factors; where long survival may be expected, surgical excision and radiation therapy with normal fractionation schedules should be planned. Current controlled studies are expected to determine the value of adjuvant hormone/cytotoxic therapy. With poor prognostic signs only systemic treatment is expected to influence survival, whereas local treatment (surgery/radiation-therapy) should be given as palliative treatment.