{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:16:16Z","timestamp":1747282576357,"version":"3.40.5"},"reference-count":62,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lymphatic drainage through the internal mammary lymph nodes (IMLN) is a key\n                        pathway for breast cancer metastasis, although IMLN metastasis is rare\n                        following primary treatment. In earlier years, treatment protocols primarily\n                        addressed axillary lymph node metastasis.<\/jats:p><jats:p>We present five cases where IMLN metastases were discovered incidentally\n                        during autologous free-flap breast reconstruction. These cases highlight\n                        implications for both the reconstructive plastic surgeon and subsequent\n                        adjuvant therapy.<\/jats:p><jats:p>From a plastic-reconstructive perspective, we recommend performing routine\n                        biopsies on any incidentally identified IMLN during autologous breast\n                        reconstruction. Positive findings may upstage the patient\u2019s disease and\n                        influence further treatment planning. However, we do not recommend actively\n                        searching for or extending dissections to harvest IMLN specimens. Only in\n                        the presence of a suspicious perinodal tumour mass do we perform an\n                        intraoperative frozen-section analysis, with reconstruction paused if\n                        malignancy is confirmed. After complete staging and discussion in a\n                        multidisciplinary conference, we proceed with tumour resection according to\n                        oncological standards if curative resection is deemed feasible.\n                        Reconstruction can then be performed during the same procedure. For\n                        locoregional recurrence of breast cancer, treatment continues to be a\n                        multimodal approach involving surgery, radiation, and systemic therapy to\n                        ensure local control and optimise long-term survival. In primary treatment,\n                        current national and international guidelines now recommend locoregional\n                        irradiation of the internal mammary chain for high-risk cases, which may\n                        further reduce the incidence of incidental IMLN metastasis findings in the\n                        future.<\/jats:p>","DOI":"10.1055\/a-2560-1560","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T22:49:41Z","timestamp":1744670981000},"page":"112-121","source":"Crossref","is-referenced-by-count":0,"title":["Incidental Findings of Internal Mammary Lymph Node Recurrence after\n                    Breast Cancer during Microsurgical Breast Reconstruction: Discussion of\n                    Treatment Options and Review of the Literature"],"prefix":"10.1055","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9789-8078","authenticated-orcid":false,"given":"Roland","family":"Hoffmeister","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Handsurgery,\n                    HELIOS Klinikum Emil von Behring Berlin-Zehlendorf,\n                    Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Therese","family":"Pross","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Charite \u2013 Universitatsmedizin\n                    Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lutz","family":"Moser","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, HELIOS Klinikum Emil von\n                    Behring Berlin-Zehlendorf, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Fricke","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Handsurgery,\n                    HELIOS Klinikum Emil von Behring Berlin-Zehlendorf,\n                    Berlin, Germany"},{"name":"Department of Plastic and Hand Surgery, University of\n                    Freiburg Medical Centre, Medical Faculty of the University\n                    of Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"von Fritschen","sequence":"additional","affiliation":[{"name":"Department of Plastic and Aesthetic Surgery, Handsurgery,\n                    HELIOS Klinikum Emil von Behring Berlin-Zehlendorf,\n                    Berlin, Germany"},{"name":"Centre of Plastic, Aesthetic, Hand and Reconstructive\n                    Surgery, University of Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"430","DOI":"10.21037\/gs.2019.12.19","article-title":"The study of internal mammary lymph node dissection guided by modified\n                    radiotracer injection technique in breast cancer-a case report and review","volume":"9","author":"Z Bi","year":"2020","journal-title":"Gland Surg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s13691-018-0344-z","article-title":"Multidisciplinary treatment for locally advanced breast cancer with internal\n                    mammary lymph node metastasis in an elderly patient","volume":"8","author":"H Takuwa","year":"2019","journal-title":"Int Cancer Conf J"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1186\/1471-2407-10-479","article-title":"Internal mammary lymph node recurrence: rare but characteristic metastasis site\n                    in breast cancer","volume":"10","author":"L Chen","year":"2010","journal-title":"BMC Cancer"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1097\/00003072-200307000-00005","article-title":"Mammographic and clinical predictors of drainage patterns in breast\n                    lymphoscintigrams obtained during sentinel node procedures","volume":"28","author":"D Lamonica","year":"2003","journal-title":"Clin Nucl Med"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.ijscr.2019.03.021","article-title":"Radical chest wall resection and modified reconstruction technique for solitary\n                    internal mammary lymph node recurrence in breast cancer","volume":"58","author":"I U Chaudhry","year":"2019","journal-title":"Int J Surg Case Rep"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12885-020-6642-9","article-title":"A retrospective analysis on metastatic rate of the internal mammary lymph node\n                    and its clinical significance in adjuvant radiotherapy of breast cancer\n                    patients","volume":"20","author":"L Li","year":"2020","journal-title":"BMC Cancer"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1007\/s10549-015-3569-y","article-title":"The clinical significance of internal mammary lymph node (IMLN) biopsy during\n                    autologous reconstruction in breast cancer patients","volume":"153","author":"X Zhang","year":"2015","journal-title":"Breast Cancer Res Treat"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"202","DOI":"10.4048\/jbc.2013.16.2.202","article-title":"The Metastatic Rate of Internal Mammary Lymph Nodes When Metastasis of Internal\n                    Mammary Lymph Node Is Suspected on PET\/CT","volume":"16","author":"J E Choi","year":"2013","journal-title":"J Breast Cancer"},{"key":"ref9","first-page":"311","article-title":"Should Internal Mammary Lymph Node Biopsy be A Routine Step in Recurrent Breast\n                    Cancer? Report of Three Cases With Negative Axilla and Positive Internal Mammary\n                    Node","volume":"2","author":"S E Chatzopoulos","year":"2011","journal-title":"World J Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1111\/ans.17982","article-title":"Internal mammary node involvement in patients with axilla-negative early breast\n                    cancer: a narrative review","volume":"93","author":"K Braue","year":"2023","journal-title":"ANZ J Surg"},{"key":"ref11","first-page":"271","article-title":"Diagnosis, treatment and prognosis of internal mammary lymph node recurrence in\n                    breast cancer patients","volume":"89","author":"S Cranenbroek","year":"2005","journal-title":"Breast Cancer Res Treat"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.breast.2009.01.005","article-title":"Chest wall resection for internal mammary lymph node metastases of breast\n                    cancer","volume":"18","author":"A N van Geel","year":"2009","journal-title":"Breast."},{"key":"ref13","doi-asserted-by":"crossref","first-page":"3879","DOI":"10.2147\/OTT.S106519","article-title":"Internal mammary sentinel lymph node biopsy: abandon or persist?","volume":"9","author":"P F Qiu","year":"2016","journal-title":"Onco Targets Ther"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1245\/s10434-018-6352-6","article-title":"Internal Mammary Lymph Node Biopsy During Free-Flap Breast Reconstruction:\n                    Optimizing Adjuvant Breast Cancer Treatment Through Comprehensive Staging","volume":"25","author":"O Ochoa","year":"2018","journal-title":"Ann Surg Oncol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1055\/s-0042-1744503","volume-title":"Internal Mammary Lymph Node Biopsy during Microsurgical Breast Reconstruction: A\n                    Prospective Study","author":"B D Schultz","year":"2022"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"917e","DOI":"10.1097\/PRS.0000000000002174","article-title":"Clinical Significance of Internal Mammary Lymph Node Biopsy during Microsurgical\n                    Breast Reconstruction: Review of 264 Cases","volume":"137","author":"E J Wright","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10051016","article-title":"Overall Complication Rates of DIEP Flap Breast Reconstructions in Germany-A\n                    Multi-Center Analysis Based on the DGPR\u00c4C Prospective National Online Registry\n                    for Microsurgical Breast Reconstructions","author":"P I Heidekrueger","year":"2021"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1056\/NEJMoa1415369","article-title":"Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer","volume":"373","author":"P M Poortmans","year":"2015","journal-title":"N Engl J Med"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.ijrobp.2013.02.037","article-title":"Long-term survival outcomes following internal mammary node irradiation in stage\n                    II-III breast cancer: results of a large retrospective study with 12-year\n                    follow-up","volume":"86","author":"J S Chang","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00066-009-1983-y","article-title":"Local relapse after breast-conserving surgery and radiotherapy: effects on\n                    survival parameters","volume":"185","author":"J Hammer","year":"2009","journal-title":"Strahlenther Onkol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4981","DOI":"10.1200\/JCO.2008.17.4862","article-title":"Internal mammary nodes in breast cancer: diagnosis and implications for patient\n                    management -- a systematic review","volume":"26","author":"R C Chen","year":"2008","journal-title":"J Clin Oncol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1602","DOI":"10.1016\/S1470-2045(20)30472-1","article-title":"Internal mammary and medial supraclavicular lymph node chain irradiation in\n                    stage I-III breast cancer (EORTC 22922\/10925): 15-year results of a randomised,\n                    phase 3 trial. European Organisation for Research and Treatment of Cancer\n                    Radiation Oncology and Breast Cancer Groups","volume":"21","author":"P M Poortmans","year":"2020","journal-title":"Lancet Oncol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1097\/GCO.0000000000000828","article-title":"Current trends in postmastectomy breast reconstruction","volume":"35","author":"U von Fritschen","year":"2023","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"06","key":"ref24","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1097\/SAP.0000000000002628","article-title":"Effect of Radiation Therapy on Microsurgical Deep Inferior Epigastric Perforator\n                    Flap Breast Reconstructions: A Matched Cohort Analysis of 4577 Cases","volume":"86","author":"L Prantl","year":"2021","journal-title":"Ann Plast Surg"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000011327","article-title":"Outcomes of Immediate versus Delayed Autologous Reconstruction with\n                    Postmastectomy Radiation: A Meta-Analysis","author":"R ElAbd","year":"2024"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1016\/j.bjps.2023.07.034","volume-title":"Internal mammary perforator vessels as recipient for microvascular breast\n                    reconstruction: Technique and outcomes in 161 flaps","author":"T R Friebel","year":"2023"},{"key":"ref27","first-page":"1879","article-title":"Regional Nodal Irradiation in Early-Stage Breast Cancer","volume":"373","author":"P M Poortmans","year":"2015","journal-title":"N Engl J Med"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1007\/s11604-018-0773-9","article-title":"Internal mammary lymph node metastases in breast cancer: what should\n                    radiologists know?","volume":"36","author":"M Urano","year":"2018","journal-title":"Jpn J Radiol"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"CR605","DOI":"10.12659\/MSM.883486","article-title":"Detecting of breast cancer metastasis by means of regional lymph node sampling\n                    during autologous breast reconstruction--a screening of 519 consecutive\n                    patients","volume":"18","author":"C Andree","year":"2012","journal-title":"Med Sci Monit"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/tbj.14105.","article-title":"Evaluation of internal mammary lymph node biopsy during microsurgical breast\n                    reconstruction: An analysis of 230 consecutive patient","volume":"27","author":"I Karanetz","year":"2021","journal-title":"Breast J"},{"issue":"12","key":"ref31","doi-asserted-by":"publisher","first-page":"e276","DOI":"10.1097\/GOX.0000000000000245","article-title":"Incidental Internal Mammary Nodes during Recipient Vessel Dissection in Breast\n                    Reconstruction: Are They Significant?","volume":"2","author":"A L Grant","year":"2015","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.ejca.2008.11.002","article-title":"Internal mammary sentinel nodes: ignore, irradiate or operate?","volume":"45","author":"N J Coombs","year":"2009","journal-title":"Eur J Cancer"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s10549-007-9561-4","article-title":"Breast cancer subpopulation with high risk of internal mammary lymph nodes\n                    metastasis: analysis of 2,269 Chinese breast cancer patients treated with\n                    extended radical mastectomy","volume":"107","author":"O Huang","year":"2008","journal-title":"Breast Cancer Res Treat"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1007\/s00259-005-1867-z","article-title":"Clinical relevance of sentinel lymph nodes in the internal mammary chain in\n                    breast cancer patients","volume":"32","author":"P Paredes","year":"2005","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1245\/ASO.2006.02.022","article-title":"The clinical value of parasternal sentinel node biopsy in breast cancer","volume":"13","author":"M H Leidenius","year":"2006","journal-title":"Ann Surg Oncol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1007\/s12282-022-01377-7","article-title":"Internal mammary lymph node metastasis in breast cancer patients based on\n                    anatomical imaging and functional imaging","volume":"29","author":"K Wang","year":"2022","journal-title":"Breast Cancer"},{"issue":"05","key":"ref37","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1054\/brst.1999.0059","article-title":"Review of internal mammary chain irradiation in breast cancer","volume":"8","author":"S K Vinod","year":"1999","journal-title":"Breast."},{"key":"ref38","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1186\/s13014-015-0568-4","article-title":"Adjuvant radiation therapy of regional lymph nodes in breast cancer \u2013 a\n                    meta-analysis of randomized trials- an update","volume":"10","author":"W Budach","year":"2015","journal-title":"Radiat Oncol"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s10549-015-3505-1","article-title":"Does internal mammary node irradiation affect treatment outcome in clinical\n                    stage II-III breast cancer patients receiving neoadjuv ant chemotherapy?","volume":"152","author":"K H Kim","year":"2015","journal-title":"Breast Cancer Res Treat"},{"key":"ref40","first-page":"276","article-title":"[Internal mammary node irradiation in early node-positive breast cancer:\n                    Improved survival]","volume":"192","author":"M L Sautter-Bihl","year":"2016","journal-title":"Strahlenther Onkol"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.ijrobp.2016.01.058","article-title":"Role of Internal Mammary Node Radiation as a Part of Modern Breast Cancer\n                    Radiation Therapy: A Systematic Review","volume":"95","author":"V Verma","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"4431","DOI":"10.1200\/JCO.2016.69.1188","article-title":"Postmastectomy Radiotherapy: An American Society of Clinical Oncology, American\n                    Society for Radiation Oncology, and Society of Surgical Oncology Focused\n                    Guideline Update","volume":"34","author":"A Recht","year":"2016","journal-title":"J Clin Oncol"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"2104","DOI":"10.1016\/S0140-6736(14)60192-6","article-title":"Postmastectomy radiation in breast cancer with one to three involved lymph\n                    nodes: ending the debate","volume":"383","author":"P. Poortmans","year":"2014","journal-title":"Lancet"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"333","DOI":"10.3109\/0284186X.2011.618510","article-title":"Radiation during deep inspiration allows loco-regional treatment of left breast\n                    and axillary-, supraclavicular- and internal mammary lymph nodes without\n                    compromising target coverage or dose restrictions to organs at risk","volume":"51","author":"M H Hjelstuen","year":"2012","journal-title":"Acta Oncol"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.bjps.2010.10.003","article-title":"An evaluation of incidental metastases to internal mammary lymph nodes detected\n                    during microvascular abdominal free flap breast reconstruction","volume":"64","author":"J T Yu","year":"2011","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref46","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.ejso.2013.03.009","article-title":"Clinical value of internal mammary lymph node metastases found incidentally\n                    during free flap recipient vessel exposure","volume":"39","author":"M V Schaverien","year":"2013","journal-title":"Eur J Surg Oncol"},{"key":"ref47","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1177\/145749690909800107","article-title":"Interoperative frozen section for margin assessment in breast conserving\n                    energy","volume":"98","author":"C Dener","year":"2009","journal-title":"Scand J Surg"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1007\/s10147-015-0827-2","article-title":"Efficacy of intraoperative entire-circumferential frozen section analysis of\n                    lumpectomy margins during breast-conserving surgery for breast cancer","volume":"20","author":"T Osako","year":"2015","journal-title":"Int J Clin Oncol"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"3204","DOI":"10.1245\/s10434-011-1956-0","article-title":"Cost-effectiveness analysis of routine frozen-section analysis of breast margins\n                    compared with reoperation for positive margins","volume":"18","author":"J B Osborn","year":"2011","journal-title":"Ann Surg Oncol"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00066-009-1984-x","article-title":"Medial tumor localization in breast cancer--an unappreciated risk factor?","volume":"185","author":"E Brautigam","year":"2009","journal-title":"Strahlenther Onkol"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.ijrobp.2013.03.021","article-title":"Ten-year survival results of a randomized trial on irradiation of internal\n                    mammary nodes after mastectomy","volume":"86","author":"C Hennequin","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"04","key":"ref53","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1056\/NEJMoa1415369","article-title":"Internal Mammary and Medial Supraclavicular Irradiation in Breast Cancer","volume":"373","author":"P M Poortmans","year":"2015","journal-title":"N Engl J Med"},{"issue":"04","key":"ref54","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1056\/NEJMoa1415340","article-title":"Regional Nodal Irradiation in Early-Stage Breast Cancer","volume":"373","author":"T J Whelan","year":"2015","journal-title":"N Engl J Med"},{"issue":"04","key":"ref55","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1200\/JCO.2015.63.6456","article-title":"A Population-Based Cohort Study on the Effect of Internal Mammary Node\n                    Irradiation in Early Node-Positive Breast Cancer","volume":"34","author":"L B Thorsen","year":"2016","journal-title":"J J Clin Oncol"},{"key":"ref56","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1200\/JCO.2017.76.5719","article-title":"Efficacy of Chemotherapy for ER-Negative and ER-Positive Isolated Locoregional\n                    Recurrence of Breast Cancer: Final Analysis of the CALOR Trial","volume":"36","author":"I L Wapnir","year":"2018","journal-title":"J Clin Oncol"},{"key":"ref57","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/S1470-2045(13)70589-8","article-title":"Chemotherapy for isolated locoregional recurrence of breast cancer (CALOR): a\n                    randomised trial","volume":"15","author":"S Aebi","year":"2014","journal-title":"Lancet Oncol"},{"key":"ref58","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1159\/000439151","article-title":"Current Treatment of Isolated Locoregional Breast Cancer Recurrences","volume":"10","author":"W Harms","year":"2015","journal-title":"Breast Care (Basel)"},{"key":"ref59","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1093\/annonc\/mdg347","article-title":"Adjuvant therapy after excision and radiation of isolated postmastectomy\n                    locoregional breast cancer recurrence: definitive results of a phase III\n                    randomized trial (SAKK 23\/82) comparing tamoxifen with observation","volume":"14","author":"M Waeber","year":"2003","journal-title":"Ann Oncol"},{"key":"ref60","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13014-019-1321-1","article-title":"Prospective results of concurrent radiation therapy and weekly paclitaxel as\n                    salvage therapy for unresectable locoregionally recurrent breast cancer","volume":"14","author":"G Cai","year":"2019","journal-title":"Radiat Oncol"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1007\/s00066-006-1549-1","article-title":"Concurrent radiotherapy and taxane chemotherapy in patients with locoregional\n                    recurrence of breast cancer. A retrospective analysis","volume":"182","author":"S Semrau","year":"2006","journal-title":"Strahlenther Onkol"},{"key":"ref62","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s13014-020-1464-0","article-title":"Optimal radiotherapy for patients with internal mammary lymph node metastasis\n                    from breast cancer","volume":"15","author":"K Yang","year":"2020","journal-title":"Radiat Oncol"},{"key":"ref63","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.clbc.2017.03.008","article-title":"Management of Isolated Locoregional Recurrences in Breast Cancer: A Review of\n                    Local and Systemic Modalities","volume":"17","author":"T Wadasadawala","year":"2017","journal-title":"Clin Breast Cancer"}],"container-title":["Handchirurgie \u00b7 Mikrochirurgie \u00b7 Plastische Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2560-1560.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T01:08:40Z","timestamp":1747271320000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2560-1560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":62,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2025,4,14]]},"published-print":{"date-parts":[[2025,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2560-1560","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"type":"print","value":"0722-1819"},{"type":"electronic","value":"1439-3980"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}