Surgical management of ipsilateral XXXX recurrence.

@entity1 @entity0 @entity2631 @entity1349
PURPOSE: Approximately 10-15% of @entity0 @entity1 treated by breast conserving surgery (BCS) and adjuvant radiotherapy (RT) will develop ipsilateral @entity0 recurrence (IBTR). International guidelines suggest total mastectomy as treatment of choice for IBTR following lumpectomy and RT. Nevertheless, there is evidence that second BCS might be equally sufficient. @entity1 AND METHODS: @entity1 with IBTR diagnosed between 1990 and 2014 after BCS and RT were included (n  =  170). 34.1% @entity1 underwent secondary BCS, whereas 65.9% were treated by mastectomy. We determined predictive factors for @entity2631 ( @entity2631 ), disease free survival (DFS), and @entity1349 ( @entity1349 ) comparing these two groups. RESULTS: Median follow-up after primary IBTR was 49 months (59 months for @entity1 still alive at time of analysis). Five-year IBTR-free rate after secondary BCS was 77.6% (SD      6.1%) and 75.0% (SD      4.5%) for @entity1 after mastectomy. Five-year DFS was 57.3% (SD      8.2%), and 61.9% (SD      5.5%), five-year @entity1349 was 84.7% (SD      5.8%), and 72.6% (SD      5.1%), respectively. Prior adjuvant systemic therapy, muscular invasion, and skin infiltration were independent significant risk factors for a shorter @entity2631 . Additionally, lymphovascular infiltration (LVI) in the IBTR increased the risk for a shorter DFS. LVI, muscular invasion, and skin infiltration were identified as independent significant risk factors for a shorter @entity1349 . CONCLUSION: No significant difference in local control, DFS, and @entity1349 was seen between IBTR @entity1 treated either by secondary BCS or mastectomy. Our data suggest that secondary BCS for IBTR @entity1 after initial BCS and RT is feasible in selected @entity1 .
