Compared with initial treatment of primary breast cancer

more uncertainties exist regarding to the prognosis and salvage therapy of local-regional recurrent breast cancer. This article summarized the pattern of recurrence after breast conservative therapy and mastectomy respectively. Comprehensive local treatment comprising re-excision and entire-field radiotherapy are the mainstay of multi-disciplinary treatment. Optimized local treatment is efficient not only in local disease control but also in preventing subsequent recurrence. Although past data did not fully justify the role of systemic treatment in local-regional recurrent patients

the result of CALOR trial

which was initiated by several international breast cancer co-operative groups has confirmed that based on individualized endocrine and targeted therapy

salvage surgery plus radiotherapy followed by systemic chemotherapy improved the disease-free survival and overall survival compared to surgery + radiotherapy alone

especially in estrogen receptor negative patients. Thus

systemic treatment based on biomarkers from primary as well as recurrent disease will become an integrated part in the therapeutic strategy of local-regional recurrent breast cancer.