- Five-year actuarial LRR and survival rates following salvage procedures for early local-only failures are similar in patients undergoing mastectomy vs BCT.
- Salvage mastectomy is generally recommended for locally recurrent breast cancer after BCS. Repeated attempts at breast conservation may be considered, preferably through participation in a clinical trial.
- To date, no published series has shown statistically significant improvement in outcome with salvage chemotherapy or hormonal therapy in the case of local recurrence after BCT.
- Multidisciplinary management of chest wall recurrence after mastectomy is warranted, including surgery, RT, and systemic therapy. In the absence of distant metastasis, aggressive attempts at salvage should be pursued.
- Multidisciplinary management of isolated axillary or supraclavicular nodal recurrence is warranted where feasible with surgery and RT, although risk of systemic failure is high. The benefit of systemic therapy in this setting remains to be determined.