ABSTRACT
Following mastectomy, loco-regional recurrence (LRR) occurs in approximately 5% to 10% of patients at 10 years following initial treatment. LRR rates are slightly higher following breast-conserving surgery versus after mastectomy, particularly in younger patients or where radiotherapy was omitted. When faced with an isolated LRR, the aim is surgical resection, with curative intent where possible. History and experience of prior breast cancer treatments should be elicited, including tolerance to chemotherapy, and the patient's views regarding future treatment modalities. Chemotherapy should be offered as first-line to patients with ER-positive, HER2-negative, inoperable LRR if they have co-existent imminently life-threatening disease, visceral crisis, for example significant symptoms from liver metastases, or are known to exhibit endocrine resistance. Capecitabine is a brilliant drug and should become the treatment of first choice. Inoperable LRRs should be considered for loco-regional and systemic treatments, with effective symptomatic management throughout in parallel.
