AB039. SOH26AB_0088. Surgical management of in-breast recurrence with completion mastectomy versus repeat breast-conserving surgery: a retrospective study
Clinical Breast Session

AB039. SOH26AB_0088. Surgical management of in-breast recurrence with completion mastectomy versus repeat breast-conserving surgery: a retrospective study

Sarah Fennelly, Denis Evoy, Jane Rothwell, Damian McCartan, Ruth Prichard, Michael Boland

Department of General Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: Breast-conserving surgery (BCS) with adjuvant radiotherapy offers oncological outcomes comparable to mastectomy for early breast cancer, with advantages in morbidity and quality of life. Salvage mastectomy is the standard treatment for ipsilateral in-breast tumour recurrence (IBTR), though repeat BCS is increasingly recommended with advances in oncoplastic techniques and repeat radiotherapy. Repeat BCS may achieve similar outcomes to mastectomy in selected patients, but the risk of further recurrence requires investigation. This study aimed to examine the surgical management of in-breast recurrent breast cancer.

Methods: This retrospective review included patients treated for breast cancer recurrence between 2000 and 2025 in the Department of General Surgery at St. Vincent’s University Hospital. Eligible patients had initial BCS followed by ipsilateral IBTR without distant disease. Variables included surgery type for recurrence, age, tumour size, radiotherapy use, recurrence interval, nodal status, and further recurrence. Numbers of patients who met published criteria for repeat BCS were compared with those who received it.

Results: Of 396 recurrent cases, 183 (46%) followed primary BCS. Twenty-eight (15.3%) underwent repeat BCS and 155 (84.6%) underwent completion mastectomy. Mean age was 49.9 years in the repeat BCS group and 53.4 years in the mastectomy group. Mean recurrent tumour size was smaller in the repeat BCS cohort (12 vs. 23.6 mm). Initial radiotherapy was given in 77%; after repeat BCS, 89% received radiotherapy. Further recurrence occurred in 17.8% after repeat BCS and 13.5% after mastectomy. Up to 45% of patients would have met contemporary criteria for repeat BCS.

Conclusions: Repeat BCS is a safe and underused option for selected IBTR cases, with recurrence rates comparable to mastectomy. Clearer selection guidelines may support broader adoption, improving patient-centred outcomes.

Keywords: Breast cancer recurrence; breast-conserving surgery (BCS); completion mastectomy; in-breast tumour recurrence (IBTR); repeat BCS

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab039
Cite this abstract as: Fennelly S, Evoy D, Rothwell J, McCartan D, Prichard R, Boland M. AB039. SOH26AB_0088. Surgical management of in-breast recurrence with completion mastectomy versus repeat breast-conserving surgery: a retrospective study. Mesentery Peritoneum 2026;10:AB039.

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