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Management of locoregional recurrence of breast cancer after mastectomy

Ariel Hirsch, MD
Michael S Sabel, MD
Daniel F Hayes, MD
Section Editor
Harold Burstein, MD, PhD
Deputy Editor
Wenliang Chen, MD, PhD


Following mastectomy for operable breast cancer, disease can recur locally, regionally, and/or at distant metastatic sites. A local recurrence is defined as reappearance of cancer on the ipsilateral chest wall. In contrast, a regional recurrence denotes tumor involving the regional lymph nodes, usually ipsilateral axillary or supraclavicular, less commonly infraclavicular and/or internal mammary nodes.

Treatment has the potential to provide long-term disease control for patients who develop an isolated locoregional recurrence after mastectomy. However, the management of these patients is complex and usually requires multidisciplinary assessment and planning.

The management of a locoregional recurrence after mastectomy for operable breast cancer will be reviewed here. The management of a local recurrence after breast-conserving therapy (BCT) is discussed elsewhere. (See "Management of locoregional recurrence of breast cancer after breast conserving therapy".)


Approximately 5 to 10 percent of patients undergoing mastectomy for operable breast cancer will have a chest wall or regional nodal recurrence within 10 years [1-7]. The risk of a postmastectomy locoregional recurrence is slightly lower than that after breast-conserving therapy (BCT, 10 to 15 percent), although it is much higher in women who undergo breast-conserving surgery without radiation therapy (RT). (See "Adjuvant radiation therapy for women with newly diagnosed, non-metastatic breast cancer".)

There are also differences in the time course, clinical features, and prognosis of a locoregional recurrence after mastectomy as compared with BCT:

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Literature review current through: Nov 2017. | This topic last updated: Oct 18, 2016.
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