Evidence map›Paper›PMID 40670668›Full record

SynthesisBreast cancer research and treatment2025

Repeat lumpectomy and external beam radiation therapy for ipsilateral breast cancer recurrence: a systematic review.

Shirley S W Tse, Caroline Hircock, Irene Karam, Hany Soliman, Shing Fung Lee, J Isabelle Choi, Jeffrey Q Cao, Tarek Hijal, Mylin Torres, Gustavo Nader Marta and 6 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Shirley S W Tse *Department of Clinical Oncology, United Christian Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong S.A.R, China.
Caroline Hircock *Department of Medicine, McMaster University, Hamilton, ON, Canada.
Irene KaramDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Hany SolimanDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Shing Fung LeeDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore, Singapore.
J Isabelle ChoiDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Jeffrey Q CaoDepartment of Oncology, Division of Radiation Oncology, University of Calgary, Calgary, AB, Canada.
Tarek HijalDepartment of Oncology, McGill University, Montreal, Canada.
Mylin TorresDepartment of Radiation Oncology, Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Gustavo Nader MartaDepartment of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil.
Adrian W ChanDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Danielle RodinRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
C Anne KochRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada.
Alyssa WangDepartment of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Edward Chow *Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Henry C Y Wong *Department of Oncology, Princess Margaret Hospital, Kowloon West Cluster, Hospital Authority, Hong Kong S.A.R, China. henrywong3011@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSalvage mastectomy is the standard of care for breast cancer patients with ipsilateral breast recurrence (IBR). This systematic review aims to evaluate effectiveness and safety of external beam RT (EBRT) as an accessible modality for repeat BCT.

methodsA systematic literature search was conducted on MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from database inception until September 22, 2024. Clinical studies that investigated the use of second BCT (repeat BCS + post-operative RT) using EBRT were included.

resultsNine articles representing 8 studies and 569 patients were included. Most studies involved patients with T1 disease (6/8 studies, 75%), and node-negative recurrence (5/8 studies, 63%) partial breast re-irradiation was employed in a majority of studies (7/8 studies, 86%). The most common dose-fractionation schedule was 45 Gy in 30 twice-daily fractions (3/8 studies, 37%), followed by 50 Gy in 25 daily fractions (2/8 studies, 25%). The median follow-up ranged from 1.5 to 15 years. The average local recurrence rate was 10%. On average, grade 3 or worse acute and late skin and soft tissue toxicities were 1% and 3%, respectively. Only one study documented the incidence of long-term cardiac mortality (4% of patients) and one reported incidence of second malignancy (3% of patients). None of the included studies assessed patient-reported outcomes using validated quality of life questionnaires.

conclusionRepeat BCT using EBRT is an emerging alternative to salvage mastectomy, offering favourable local control and acceptable rates of treatment-related toxicities.

Indexed as

Breast NeoplasmsMastectomy, SegmentalNeoplasm Recurrence, LocalFemaleHumansQuality of LifeRe-IrradiationReoperationSalvage TherapyTreatment OutcomeBreast cancerLocoregional recurrenceRe-irradiationSalvage therapy

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.