NCCN breast cancer RT guidelines: hypofractionation preferred

Recurrence

For women with local-only recurrence, the guidelines recommend mastectomy with axillary lymph node staging for those with recurrences after initial lumpectomy and radiation, or if the initial treatment was mastectomy with no radiation, surgical resection with radiation, or surgical resection alone for those women previously treated with mastectomy and radiation.

For regional or locoregional recurrences, the guidelines recommend that axillary recurrences be treated with surgery and radiation if possible, and that supraclavicular or internal mammary node recurrences be treated with radiation therapy, if possible.