Clinical Practice Guidelines for the Diagnosis, Treatment and Management of Breast Cancer

Dear Colleagues,

Breast cancer is a significant health issue worldwide, and clinical practice guidelines (CPGs) for its diagnosis, treatment and management play a critical role in improving patient outcomes. This Special Issue aims to reflect on the current status of research on breast cancer CPGs, identify the core problems to be solved and promote the development and dissemination of evidence-based CPGs.

This Special Issue will cover a broad range of topics, including the development and evaluation of breast cancer CPGs, the impact of CPGs on patient outcomes and the challenges of implementing CPGs in clinical practice. The articles included in the issue need to provide insights into the current state of breast cancer CPGs, including their strengths and limitations, and highlight areas for improvement.

The main goal of this Special Issue is to raise awareness of the importance of evidence-based CPGs in breast cancer diagnosis, treatment and management. It will provide an opportunity for researchers, clinicians and patients to collaborate and share knowledge to improve the quality of breast cancer care.

Overall, this Special Issue on Clinical Practice Guidelines for the Diagnosis, Treatment and Management of Breast Cancer will be a valuable resource for healthcare professionals and stakeholders involved in breast cancer care. It will provide a comprehensive overview of the current state of breast cancer CPGs and highlight the need for ongoing research and collaboration to improve patient outcomes.

Dr. Roberto Cuomo
Dr. Luigi Marano
Dr. Donato Casella
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

• breast cancer
• clinical practice guideline
• diagnosis
• treatment
• management

Title: Recurrent ipsilateral breast cancer: Surgical Management and Implications on adjuvant treatment and recurrence
Authors: Ines Torras; Isaac Cebrecos; Helena Castillo; Laura Rodriguez; Pablo Zaragoza-Basllester; Carla Sitges; Ignacio Loinaz; Marta Garcia; Mertixell Molla; Sergi Vidal-Sicart; Eduard Mension
Affiliation: Hospital Clínic de Barcelona
Abstract: Introduction: Breast cancer (BC) recurrence, defined as the reappearance of cancer in the ipsilateral breast following primary treatment, presents significant challenges in clinical management and patient outcomes. Despite advancements in treatment modalities, the risk of recurrence persists, with annual rates ranging from 0.6-1.5%, escalating to 10-15% at 20 years. Understanding the patterns, risk factors, and optimal strategies for managing local recurrences is crucial for improving patient care and prognosis. The aim of this study was to analize the surgical and oncological carachteristics of a cohort of patients who suffered BC recurrence. Materials and Methods: This retrospective study included 56 patients diagnosed with recurrent BC between October 2018 and April 2022. Data were collected from a prospectively maintained surgical database. A descriptive analysis of the surgical and oncological carachteristics of the initial BC and the BC recurrence was performed. The surgical complications were classified according to the Clavien-Dindo system. The success rates of performing selective sentinel lymph node biopsy (SLN) and aberrant drainage were assessed by previous surgery. Results: The cohort included 55 females and 1 male, with a median age of 65.3 years. The mean time to BC recurrence was 11.5 years. Of those, 26.8% underwent breast-conserving surgery, 41.1% had a mastectomy, 21.4% had mastectomy with reconstruction, and 10.7% had excision over previous mastectomy. SLN biopsy was performed in 78.6% of cases, with a higher success rate in those without previous axillary lymph node dissection (ALND) (85.7% vs. 63.2%, p=0.06). Aberrant drainage was observed more frequently in patients with previous ALND (44.4% vs. 20%, p=0.06). The median follow-up period was 41.3 months, with 10.7% experiencing a second recurrence. Conclusion: The surgical management of BC recurrence entails different challenges, nonetheless, repeat BCS with reirradiation for ipsilateral recurrence is feasible and does not significantly increase complications. Immediate reconstruction should be considered when undergoing a mastectomy. On the other hand, the use of SLN is valuable in restaging and tailoring adjuvant therapies, with ALND not necessary if re-SLN shows no drainage. The management of aberrant drainage patterns remains controversial. Further research is needed to explore long-term outcomes and refine guidelines for managing recurrent breast cancer.