Oncology (Williston Park). 2014 Feb;28(2):157-64, C3.
Although both breast-conserving surgery and mastectomy generally provide excellent local-regional control of breast cancer, local-regional recurrence (LRR) does occur. Predictors for LRR include patient, tumor, and treatment-related factors. Salvage after LRR includes coordination of available modalities, including surgery, radiation, chemotherapy, and hormonal therapy, depending on the clinical scenario. Management recommendations for breast cancer LRR, including patient scenarios, are reviewed, and represent evidence-based data and expert opinion of the American College of Radiology Appropriateness Criteria Expert Panel on LRR.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel.The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
虽然保乳手术和乳房切除术通常都能为乳腺癌提供出色的局部区域控制，但局部区域复发（LRR）确实会发生。LRR 的预测因素包括患者、肿瘤和治疗相关因素。LRR 后的挽救治疗包括协调可用的治疗方式，包括手术、放疗、化疗和激素治疗，具体取决于临床情况。对 LRR 后的乳腺癌管理建议进行了审查，包括患者情况，并代表了美国放射学院适当性标准 LRR 专家小组的循证数据和专家意见。美国放射学院适当性标准是针对特定临床情况的循证指南，每两年由多学科专家小组进行审查。指南的制定和审查包括对同行评议期刊的现有医学文献进行广泛分析，并应用成熟的共识方法（改良 Delphi 法）对小组进行成像和治疗程序的适当性进行评分。在证据不足或不确定的情况下，可以使用专家意见来推荐成像或治疗。
