Management strategy for locoregional recurrent breast cancer after conservative therapy

Background and aim Local recurrence following breast-conserving surgery is usually invasive and occurs near the original tumor bed; while salvage mastectomy remains the standard management, selected patients with small, late recurrences may be candidates for repeat conservative surgery with comparable oncologic outcomes. We aimed to outline management strategy for locoregional recurrent breast cancer following conservative therapy. Patients and methods This prospective research involved 50 females’ cases with recurrent breast cancer after conservative operation. The research was done at the General Surgery Department, Al-Azhar University, Assiut Hospital and Surgical Oncology Department, South Egypt Cancer Institute in the period starting from April 2024 to April 2025. Results Mean age was 48.4±9.8 years; 64% premenopausal, 36% postmenopausal, 60% positive family history, 58% multipara, 72% had contraception history. Among 50 cases, local recurrence was most common (34), locoregional (10), regional (6); 28 tumors at same site, 16 at different site, six axillary recurrences. Pathology: 38 intraductal, 12 intralobular; extensive intraductal component positive in 44, lymphovascular invasion in 38, 60% high grade, 38 free margins. Histopathology and lymphovascular invasion are significantly associated with recurrence. Among 44 surgically treated cases, 14 had wide local excision, 30 completion mastectomy. Conclusion Surgical intervention followed by hormonal or targeted therapy was the main management for locoregional recurrence after conservative breast surgery, while regional recurrence relied mainly on hormonal or targeted therapy, with limited roles for axillary dissection, chemotherapy, or radiotherapy.