Ipsilateral breast tumor recurrence following conservative surgery and radiation therapy

Ipsilateral breast tumor recurrence occurs in approximately 10% to 15% of patients undergoing conservative surgery and definitive radiation therapy. Mammography alone detects one third of breast recurrences. Most recurrences are invasive, few demonstrate simultaneous distant metastasis, and approximately 40% have axillary lymph node involvement. Mastectomy is the standard salvage procedure. Axillary lymph node dissection may help guide adjuvant treatment as well as reduce the risk of a subsequent regional recurrence. The decision of whether to use adjuvant therapy should be based on tumor size, lymph node status, receptor status, DNA index, S-phase fraction, and disease-free interval. Ipsilateral recurrence may be an independent prognostic factor for distant metastasis.