الفهرس | Only 14 pages are availabe for public view |
Abstract F Summary and Conclusion or the patient, LR of breast carcinoma poses a daunting reality, and for the clinician, it poses a diagnostic and treatment challenge. Maintaining a good clinical practice of thorough history taking and physical examination with the addition of appropriate surveillance studies is the mainstay for diagnosis. As BCT has emerged as the treatment of choice for early-stage breast cancer, the pursuit of factors instigating LR are ongoing, with margin status, patient young age, and tumor biology the focus of much study. Local failure is often the harbinger of distant disease, and early recurrence certainly portends a more dismal outcome; however, this should not thwart appropriate treatment intervention. Most IBTRs can be managed with salvage mastectomy, and repeat local surgical therapy is an alternative in select cases. The addition of chemohormonal and radiation therapy is the subject of ongoing investigation and often is offered based on clinical wisdom rather than reported data at this point. Lastly, there is evidence to suggest that differentiating true LR from a new ipsilateral breast cancer can favorably impact the patient’s prognosis and clinical course and subsequently change treatment decision making by the physician. |