Open AccessACR Appropriateness Criteria® Local-regional Recurrence (LR) and Salvage Surgery
Author(s) -
Michele Y. Halyard,
Nabil Wasif,
Eleanor Harris,
Douglas W. Arthur,
Lisa Bailey,
Jennifer R. Bellon,
Lisa A. Carey,
Sharad Goyal,
Kathleen C. Horst,
Meena S. Moran,
Shan M. MacDonald,
Bruce G. Haffty
Publication year - 2012
Publication title -
american journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.896
H-Index - 78
eISSN - 1537-453X
pISSN - 0277-3732
DOI - 10.1097/coc.0b013e3182439084
Subject(s) - medicine , mastectomy , appropriate use criteria , guideline , appropriateness criteria , expert opinion , breast cancer , medical physics , multidisciplinary approach , radiological weapon , medline , delphi method , radiation therapy , cancer , surgery , intensive care medicine , radiology , pathology , social science , statistics , mathematics , sociology , political science , law
Despite the success of both breast conserving surgery and mastectomy, some women will experience a local-regional recurrence (LRR) of their breast cancer. Predictors for LRR after breast-conserving therapy or mastectomy have been identified, including patient, tumor, and treatment-related factors. The role of surgery, radiation, and chemotherapy as treatment has evolved over time and many patients now have the potential for salvage after LRR. This review of LRR of breast cancer and management recommendations, including the use of common clinical scenarios, represents a compilation of evidence-based data and expert opinion of the American College of Radiology Appropriateness Criteria Expert Panel on local-regional recurrence. 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 those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.