Outcomes from ipsilateral breast tumor recurrence after breast conserving surgery and whole breast irradiation for breast cancer

The preferred treatment of ipsilateral breast tumor recurrence after breast conservation surgery and whole breast irradiation for breast cancer has traditionally been total mastectomy, but in the last five years there have been reports, including the article accompanying this commentary, using skin- and nipple-sparing mastectomies with immediate tissue expander, direct-to-implant, or autologous flap reconstructions.1,2 However, it is important to put surgical decision-making into the context of the biology associated with this type of recurrence. Prognostic factors associated with worse survival are time to recurrence