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Recurrent Breast Carcinoma
Laurie Margolies, MD; Wei Tse Yang, MBBS; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Local recurrence, locoregional recurrence
          • Definitions

            • Invasive breast cancer &/or DCIS in breast previously treated for cancer or chest wall recurrence after mastectomy
            • Breast-conserving therapy (BCT) = breast-conserving surgery (BCS) followed by radiation therapy (XRT)
            • True recurrence = local failure
            • Recurrence in ipsilateral breast remote from primary site may be new primary cancer
            • Contralateral breast cancer: Typically considered second primary and not recurrence
            • Contralateral axillary disease may be locoregional recurrence due to altered nodal drainage

          IMAGING

          • General Features

            • Mammographic Findings

              • Ultrasonographic Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Image-Guided Biopsy

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Aalders KC et al: Do patients whose tumor achieved a pathological response relapse at specific sites? A substudy of the EORTC 10994/BIG-1-00 trial. Breast Cancer Res Treat. 169(3):497-505, 2018
                                          2. Jones T et al: Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry. Breast Cancer Res Treat. 169(1):141-52, 2018
                                          3. Lee JM et al: Cumulative risk distribution for interval invasive second breast cancers after negative surveillance mammography. J Clin Oncol. 36(20):2070-77, 2018
                                          4. Lowry KP et al: Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Res Treat. 171(1):209-15, 2018
                                          5. Monticciolo DL et al: Breast cancer screening in women at higher-than-average risk: recommendations from the acr. J Am Coll Radiol. 15(3 Pt A):408-14, 2018
                                          6. Pilewskie M et al: Margins in breast cancer: how much is enough? Cancer. 124(7):1335-41, 2018
                                          7. Poodt IGM et al: Risk of regional recurrence after negative repeat sentinel lymph node biopsy in patients with ipsilateral breast tumor recurrence. Ann Surg Oncol. 25(5):1312-21, 2018
                                          8. Saha A et al: A study of association of Oncotype DX recurrence score with DCE-MRI characteristics using multivariate machine learning models. J Cancer Res Clin Oncol. 144(5):799-807, 2018
                                          9. Shin SU et al: Neoadjuvant chemotherapy and surgery for breast cancer: preoperative mri features associated with local recurrence. Radiology. 172888, 2018
                                          10. Turashvili G et al: The 21-Gene Recurrence Score in Male Breast Cancer. Ann Surg Oncol. 25(6):1530-35, 2018
                                          11. Zakeri K et al: Radiation oncology in the 21st century: prospective randomized trials that changed practice… or didn't! Front Oncol. 8:130, 2018
                                          12. Chu AJ et al: Imaging surveillance for survivors of breast cancer: correlation between cancer characteristics and method of detection. J Breast Cancer. 20(2):192-197, 2017
                                          13. Dutta SW et al: Intraoperative radiation therapy for breast cancer patients: current perspectives. Breast Cancer (Dove Med Press). 9:257-63, 2017
                                          14. Gingerich J et al: Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature. Int J Surg Case Rep. 40:47-49, 2017
                                          15. Mannell A: An overview of risk factors for recurrent breast cancer. S Afr J Surg. 55(1):29-34, 2017
                                          16. Strnad V et al: 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet. 387(10015):229-38, 2016
                                          17. Moossdorff M et al: Contralateral lymph node recurrence in breast cancer: regional event rather than distant metastatic disease. A systematic review of the literature. Eur J Surg Oncol. 41(9):1128-36, 2015
                                          18. Poortmans PM et al: Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med. 373(4):317-27, 2015
                                          19. Whelan TJ et al: Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 373(4):307-16, 2015
                                          20. Cuzick J: Radiotherapy for breast cancer, the TARGIT-A trial. Lancet. 383(9930):1716, 2014
                                          21. Vaidya JS et al: Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet. 383(9917):603-13, 2014
                                          22. Carlson JJ et al: The impact of the Oncotype Dx breast cancer assay in clinical practice: a systematic review and meta-analysis. Breast Cancer Res Treat. 141(1):13-22, 2013
                                          23. Haviland JS et al: The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol. 14(11):1086-94, 2013
                                          24. Khatcheressian JL et al: Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 31(7):961-5, 2013
                                          25. Klein ME et al: Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis. Mod Pathol. 26(5):658-64, 2013
                                          26. Maaskant-Braat AJ et al: Repeat sentinel node biopsy in patients with locally recurrent breast cancer: a systematic review and meta-analysis of the literature. Breast Cancer Res Treat. 138(1):13-20, 2013
                                          27. McLaughlin SA: Surgical management of the breast: breast conservation therapy and mastectomy. Surg Clin North Am. 93(2):411-28, 2013
                                          28. Veronesi U et al: Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomised controlled equivalence trial. Lancet Oncol. 14(13):1269-77, 2013
                                          29. Arasu VA et al: Benefit of semiannual ipsilateral mammographic surveillance following breast conservation therapy. Radiology. 264(2):371-7, 2012
                                          30. Chansakul T et al: The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 198(2):321-30, 2012
                                          31. Chansakul T et al: The postconservation breast: part 2, Imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 198(2):331-43, 2012
                                          32. Drukteinis JS et al: MR imaging assessment of the breast after breast conservation therapy: distinguishing benign from malignant lesions. Radiographics. 32(1):219-34, 2012
                                          33. Gunia SR et al: Evaluation of appropriate short-term mammographic surveillance in patients who undergo breast-conserving Surgery (BCS). Ann Surg Oncol. 19(10):3139-43, 2012
                                          34. Manohar K et al: Clinical utility of F-18 FDG PET/CT in recurrent breast carcinoma. Nucl Med Commun. 33(6):591-6, 2012
                                          35. Quinn EM et al: Use of magnetic resonance imaging in detection of breast cancer recurrence: a systematic review. Ann Surg Oncol. 19(9):3035-41, 2012
                                          36. Kim SJ et al: The detection of recurrent breast cancer in patients with a history of breast cancer surgery: comparison of clinical breast examination, mammography and ultrasonography. Acta Radiol. 52(1):15-20, 2011
                                          37. Peng C et al: MRI appearance of tumor recurrence in myocutaneous flap reconstruction after mastectomy. AJR Am J Roentgenol. 196(4):W471-5, 2011
                                          38. Vanderwalde LH et al: Breast MRI after bilateral mastectomy: is it indicated? Am Surg. 77(2):180-4, 2011
                                          39. Aukema TS et al: The role of FDG PET/CT in patients with locoregional breast cancer recurrence: a comparison to conventional imaging techniques. Eur J Surg Oncol. 36(4):387-92, 2010
                                          40. Li J et al: Breast MRI after conservation therapy: usual findings in routine follow-up examinations. AJR Am J Roentgenol. 195(3):799-807, 2010
                                          41. Whelan TJ et al: Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med. 362(6):513-20, 2010
                                          42. Anderson SJ et al: Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 27(15):2466-73, 2009
                                          43. Lee JM et al: Detecting nonpalpable recurrent breast cancer: the role of routine mammographic screening of transverse rectus abdominis myocutaneous flap reconstructions. Radiology. 248(2):398-405, 2008
                                          44. START Trialists' Group. et al: The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 371(9618):1098-107, 2008
                                          45. START Trialists' Group et al: The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 9(4):331-41, 2008
                                          46. Huston TL et al: The presentation of contralateral axillary lymph node metastases from breast carcinoma: a clinical management dilemma. Breast J. 13(2):158-64, 2007
                                          47. Lash TL et al: Reduced mortality rate associated with annual mammograms after breast cancer therapy. Breast J. 12(1):2-6, 2006
                                          48. van der Sangen MJ et al: The prognosis of patients with local recurrence more than five years after breast conservation therapy for invasive breast carcinoma. Eur J Surg Oncol. 32(1):34-8, 2006
                                          49. Immonen-Räihä P et al: Mammographic screening reduces risk of breast carcinoma recurrence. Cancer. 103(3):474-82, 2005
                                          50. Kirova YM et al: Radiation-induced sarcomas after radiotherapy for breast carcinoma: a large-scale single-institution review. Cancer. 104(4):856-63, 2005
                                          51. Warren JL et al: The frequency of ipsilateral second tumors after breast-conserving surgery for DCIS: a population based analysis. Cancer. 104(9):1840-8, 2005
                                          52. Fischer U et al: The influence of preoperative MRI of the breasts on recurrence rate in patients with breast cancer. Eur Radiol. 14(10):1725-31, 2004
                                          53. Harris JR et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 1067-87, 2004
                                          54. Mollick JA et al: Rational surveillance programs for early stage breast cancer patients after primary treatment. Breast Dis. 21:47-54, 2004
                                          55. Paik S et al: A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 351(27):2817-26, 2004
                                          56. Kamel EM et al: [18F]-Fluorodeoxyglucose positron emission tomography in patients with suspected recurrence of breast cancer. J Cancer Res Clin Oncol. 129(3):147-53, 2003
                                          57. Dershaw DD: Breast imaging and the conservative treatment of breast cancer. Radiol Clin North Am. 40(3):501-16, 2002
                                          58. Fisher B et al: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 347(16):1233-41, 2002
                                          59. Rodrigues N et al: Correlation of clinical and pathologic features with outcome in patients with ductal carcinoma in situ of the breast treated with breast-conserving surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 54(5):1331-5, 2002
                                          60. Weight SC et al: Optimizing surveillance mammography following breast conservation surgery. Eur J Surg Oncol. 28(1):11-3, 2002
                                          61. Lagrange JL et al: Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiation Therapist and Pathologist Groups of the Fédération Nationale des Centres de Lutte Contre le Cancer. Radiology. 216(1):197-205, 2000
                                          62. Solomon B et al: Delayed development of enhancement in fat necrosis after breast conservation therapy: a potential pitfall of MR imaging of the breast. AJR Am J Roentgenol. 170(4):966-8, 1998
                                          63. Rieber A et al: Value of MR mammography in the detection and exclusion of recurrent breast carcinoma. J Comput Assist Tomogr. 21(5):780-4, 1997
                                          64. Brenner RJ et al: Mammographic features after conservation therapy for malignant breast disease: serial findings standardized by regression analysis. AJR Am J Roentgenol. 167(1):171-8, 1996
                                          65. Fisher B et al: Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 333(22):1456-61, 1995
                                          66. Dershaw DD et al: Detection of local recurrence after conservative therapy for breast carcinoma. Cancer. 70(2):493-6, 1992
                                          67. Orel SG et al: Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection. Radiology. 183(1):201-6, 1992
                                          68. Recht A et al: Time-course of local recurrence following conservative surgery and radiotherapy for early stage breast cancer. Int J Radiat Oncol Biol Phys. 15(2):255-61, 1988
                                          69. Stomper PC et al: Mammographic detection of recurrent cancer in the irradiated breast. AJR Am J Roentgenol. 148(1):39-43, 1987
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Local recurrence, locoregional recurrence
                                                  • Definitions

                                                    • Invasive breast cancer &/or DCIS in breast previously treated for cancer or chest wall recurrence after mastectomy
                                                    • Breast-conserving therapy (BCT) = breast-conserving surgery (BCS) followed by radiation therapy (XRT)
                                                    • True recurrence = local failure
                                                    • Recurrence in ipsilateral breast remote from primary site may be new primary cancer
                                                    • Contralateral breast cancer: Typically considered second primary and not recurrence
                                                    • Contralateral axillary disease may be locoregional recurrence due to altered nodal drainage

                                                  IMAGING

                                                  • General Features

                                                    • Mammographic Findings

                                                      • Ultrasonographic Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Image-Guided Biopsy

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Aalders KC et al: Do patients whose tumor achieved a pathological response relapse at specific sites? A substudy of the EORTC 10994/BIG-1-00 trial. Breast Cancer Res Treat. 169(3):497-505, 2018
                                                                                  2. Jones T et al: Surveillance for cancer recurrence in long-term young breast cancer survivors randomly selected from a statewide cancer registry. Breast Cancer Res Treat. 169(1):141-52, 2018
                                                                                  3. Lee JM et al: Cumulative risk distribution for interval invasive second breast cancers after negative surveillance mammography. J Clin Oncol. 36(20):2070-77, 2018
                                                                                  4. Lowry KP et al: Predictors of surveillance mammography outcomes in women with a personal history of breast cancer. Breast Cancer Res Treat. 171(1):209-15, 2018
                                                                                  5. Monticciolo DL et al: Breast cancer screening in women at higher-than-average risk: recommendations from the acr. J Am Coll Radiol. 15(3 Pt A):408-14, 2018
                                                                                  6. Pilewskie M et al: Margins in breast cancer: how much is enough? Cancer. 124(7):1335-41, 2018
                                                                                  7. Poodt IGM et al: Risk of regional recurrence after negative repeat sentinel lymph node biopsy in patients with ipsilateral breast tumor recurrence. Ann Surg Oncol. 25(5):1312-21, 2018
                                                                                  8. Saha A et al: A study of association of Oncotype DX recurrence score with DCE-MRI characteristics using multivariate machine learning models. J Cancer Res Clin Oncol. 144(5):799-807, 2018
                                                                                  9. Shin SU et al: Neoadjuvant chemotherapy and surgery for breast cancer: preoperative mri features associated with local recurrence. Radiology. 172888, 2018
                                                                                  10. Turashvili G et al: The 21-Gene Recurrence Score in Male Breast Cancer. Ann Surg Oncol. 25(6):1530-35, 2018
                                                                                  11. Zakeri K et al: Radiation oncology in the 21st century: prospective randomized trials that changed practice… or didn't! Front Oncol. 8:130, 2018
                                                                                  12. Chu AJ et al: Imaging surveillance for survivors of breast cancer: correlation between cancer characteristics and method of detection. J Breast Cancer. 20(2):192-197, 2017
                                                                                  13. Dutta SW et al: Intraoperative radiation therapy for breast cancer patients: current perspectives. Breast Cancer (Dove Med Press). 9:257-63, 2017
                                                                                  14. Gingerich J et al: Contralateral axillary lymph node metastasis in second primary Breast cancer: Case report and review of the literature. Int J Surg Case Rep. 40:47-49, 2017
                                                                                  15. Mannell A: An overview of risk factors for recurrent breast cancer. S Afr J Surg. 55(1):29-34, 2017
                                                                                  16. Strnad V et al: 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet. 387(10015):229-38, 2016
                                                                                  17. Moossdorff M et al: Contralateral lymph node recurrence in breast cancer: regional event rather than distant metastatic disease. A systematic review of the literature. Eur J Surg Oncol. 41(9):1128-36, 2015
                                                                                  18. Poortmans PM et al: Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med. 373(4):317-27, 2015
                                                                                  19. Whelan TJ et al: Regional nodal irradiation in early-stage breast cancer. N Engl J Med. 373(4):307-16, 2015
                                                                                  20. Cuzick J: Radiotherapy for breast cancer, the TARGIT-A trial. Lancet. 383(9930):1716, 2014
                                                                                  21. Vaidya JS et al: Risk-adapted targeted intraoperative radiotherapy versus whole-breast radiotherapy for breast cancer: 5-year results for local control and overall survival from the TARGIT-A randomised trial. Lancet. 383(9917):603-13, 2014
                                                                                  22. Carlson JJ et al: The impact of the Oncotype Dx breast cancer assay in clinical practice: a systematic review and meta-analysis. Breast Cancer Res Treat. 141(1):13-22, 2013
                                                                                  23. Haviland JS et al: The UK Standardisation of Breast Radiotherapy (START) trials of radiotherapy hypofractionation for treatment of early breast cancer: 10-year follow-up results of two randomised controlled trials. Lancet Oncol. 14(11):1086-94, 2013
                                                                                  24. Khatcheressian JL et al: Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 31(7):961-5, 2013
                                                                                  25. Klein ME et al: Prediction of the Oncotype DX recurrence score: use of pathology-generated equations derived by linear regression analysis. Mod Pathol. 26(5):658-64, 2013
                                                                                  26. Maaskant-Braat AJ et al: Repeat sentinel node biopsy in patients with locally recurrent breast cancer: a systematic review and meta-analysis of the literature. Breast Cancer Res Treat. 138(1):13-20, 2013
                                                                                  27. McLaughlin SA: Surgical management of the breast: breast conservation therapy and mastectomy. Surg Clin North Am. 93(2):411-28, 2013
                                                                                  28. Veronesi U et al: Intraoperative radiotherapy versus external radiotherapy for early breast cancer (ELIOT): a randomised controlled equivalence trial. Lancet Oncol. 14(13):1269-77, 2013
                                                                                  29. Arasu VA et al: Benefit of semiannual ipsilateral mammographic surveillance following breast conservation therapy. Radiology. 264(2):371-7, 2012
                                                                                  30. Chansakul T et al: The postconservation breast: part 1, Expected imaging findings. AJR Am J Roentgenol. 198(2):321-30, 2012
                                                                                  31. Chansakul T et al: The postconservation breast: part 2, Imaging findings of tumor recurrence and other long-term sequelae. AJR Am J Roentgenol. 198(2):331-43, 2012
                                                                                  32. Drukteinis JS et al: MR imaging assessment of the breast after breast conservation therapy: distinguishing benign from malignant lesions. Radiographics. 32(1):219-34, 2012
                                                                                  33. Gunia SR et al: Evaluation of appropriate short-term mammographic surveillance in patients who undergo breast-conserving Surgery (BCS). Ann Surg Oncol. 19(10):3139-43, 2012
                                                                                  34. Manohar K et al: Clinical utility of F-18 FDG PET/CT in recurrent breast carcinoma. Nucl Med Commun. 33(6):591-6, 2012
                                                                                  35. Quinn EM et al: Use of magnetic resonance imaging in detection of breast cancer recurrence: a systematic review. Ann Surg Oncol. 19(9):3035-41, 2012
                                                                                  36. Kim SJ et al: The detection of recurrent breast cancer in patients with a history of breast cancer surgery: comparison of clinical breast examination, mammography and ultrasonography. Acta Radiol. 52(1):15-20, 2011
                                                                                  37. Peng C et al: MRI appearance of tumor recurrence in myocutaneous flap reconstruction after mastectomy. AJR Am J Roentgenol. 196(4):W471-5, 2011
                                                                                  38. Vanderwalde LH et al: Breast MRI after bilateral mastectomy: is it indicated? Am Surg. 77(2):180-4, 2011
                                                                                  39. Aukema TS et al: The role of FDG PET/CT in patients with locoregional breast cancer recurrence: a comparison to conventional imaging techniques. Eur J Surg Oncol. 36(4):387-92, 2010
                                                                                  40. Li J et al: Breast MRI after conservation therapy: usual findings in routine follow-up examinations. AJR Am J Roentgenol. 195(3):799-807, 2010
                                                                                  41. Whelan TJ et al: Long-term results of hypofractionated radiation therapy for breast cancer. N Engl J Med. 362(6):513-20, 2010
                                                                                  42. Anderson SJ et al: Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 27(15):2466-73, 2009
                                                                                  43. Lee JM et al: Detecting nonpalpable recurrent breast cancer: the role of routine mammographic screening of transverse rectus abdominis myocutaneous flap reconstructions. Radiology. 248(2):398-405, 2008
                                                                                  44. START Trialists' Group. et al: The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 371(9618):1098-107, 2008
                                                                                  45. START Trialists' Group et al: The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 9(4):331-41, 2008
                                                                                  46. Huston TL et al: The presentation of contralateral axillary lymph node metastases from breast carcinoma: a clinical management dilemma. Breast J. 13(2):158-64, 2007
                                                                                  47. Lash TL et al: Reduced mortality rate associated with annual mammograms after breast cancer therapy. Breast J. 12(1):2-6, 2006
                                                                                  48. van der Sangen MJ et al: The prognosis of patients with local recurrence more than five years after breast conservation therapy for invasive breast carcinoma. Eur J Surg Oncol. 32(1):34-8, 2006
                                                                                  49. Immonen-Räihä P et al: Mammographic screening reduces risk of breast carcinoma recurrence. Cancer. 103(3):474-82, 2005
                                                                                  50. Kirova YM et al: Radiation-induced sarcomas after radiotherapy for breast carcinoma: a large-scale single-institution review. Cancer. 104(4):856-63, 2005
                                                                                  51. Warren JL et al: The frequency of ipsilateral second tumors after breast-conserving surgery for DCIS: a population based analysis. Cancer. 104(9):1840-8, 2005
                                                                                  52. Fischer U et al: The influence of preoperative MRI of the breasts on recurrence rate in patients with breast cancer. Eur Radiol. 14(10):1725-31, 2004
                                                                                  53. Harris JR et al: Diseases of the Breast. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 1067-87, 2004
                                                                                  54. Mollick JA et al: Rational surveillance programs for early stage breast cancer patients after primary treatment. Breast Dis. 21:47-54, 2004
                                                                                  55. Paik S et al: A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer. N Engl J Med. 351(27):2817-26, 2004
                                                                                  56. Kamel EM et al: [18F]-Fluorodeoxyglucose positron emission tomography in patients with suspected recurrence of breast cancer. J Cancer Res Clin Oncol. 129(3):147-53, 2003
                                                                                  57. Dershaw DD: Breast imaging and the conservative treatment of breast cancer. Radiol Clin North Am. 40(3):501-16, 2002
                                                                                  58. Fisher B et al: Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 347(16):1233-41, 2002
                                                                                  59. Rodrigues N et al: Correlation of clinical and pathologic features with outcome in patients with ductal carcinoma in situ of the breast treated with breast-conserving surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 54(5):1331-5, 2002
                                                                                  60. Weight SC et al: Optimizing surveillance mammography following breast conservation surgery. Eur J Surg Oncol. 28(1):11-3, 2002
                                                                                  61. Lagrange JL et al: Sarcoma after radiation therapy: retrospective multiinstitutional study of 80 histologically confirmed cases. Radiation Therapist and Pathologist Groups of the Fédération Nationale des Centres de Lutte Contre le Cancer. Radiology. 216(1):197-205, 2000
                                                                                  62. Solomon B et al: Delayed development of enhancement in fat necrosis after breast conservation therapy: a potential pitfall of MR imaging of the breast. AJR Am J Roentgenol. 170(4):966-8, 1998
                                                                                  63. Rieber A et al: Value of MR mammography in the detection and exclusion of recurrent breast carcinoma. J Comput Assist Tomogr. 21(5):780-4, 1997
                                                                                  64. Brenner RJ et al: Mammographic features after conservation therapy for malignant breast disease: serial findings standardized by regression analysis. AJR Am J Roentgenol. 167(1):171-8, 1996
                                                                                  65. Fisher B et al: Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 333(22):1456-61, 1995
                                                                                  66. Dershaw DD et al: Detection of local recurrence after conservative therapy for breast carcinoma. Cancer. 70(2):493-6, 1992
                                                                                  67. Orel SG et al: Breast cancer recurrence after lumpectomy and irradiation: role of mammography in detection. Radiology. 183(1):201-6, 1992
                                                                                  68. Recht A et al: Time-course of local recurrence following conservative surgery and radiotherapy for early stage breast cancer. Int J Radiat Oncol Biol Phys. 15(2):255-61, 1988
                                                                                  69. Stomper PC et al: Mammographic detection of recurrent cancer in the irradiated breast. AJR Am J Roentgenol. 148(1):39-43, 1987