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New research · Oncology
The Lancet. Oncology · 4d
ReviewThe Lancet. Oncology · 2026

Local management of second ipsilateral breast cancer events after primary breast-conserving therapy: an international Delphi consensus.

Jean-Michel Hannoun-Levi, Julie A Margenthaler, Bethany Anderson … Frederick M Dirbas
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OncologyReview

Experts reached consensus on local management for most second ipsilateral breast cancer events.

Local management of second ipsilateral breast cancer events after primary breast-conserving therapy: an international Delphi consensus.

Jean-Michel Hannoun-Levi … Frederick M Dirbas
The Lancet. Oncology · 2026
Background

Management of second ipsilateral breast cancer events (iBCEs) remains controversial, and there is a need to collate existing evidence and international guidance on patient selection and local treatment strategies.

Purpose

This project, endorsed by US and European surgical and radiation oncology societies, aimed to gather expert consensus on these issues.

80%
Results
80%
experts agreed on most questions about managing second breast cancer events
More results

Consensus was predefined as agreement of 75% or higher.

Panellists agreed that patient preferences are central to decision making (100%) and that a second breast-conserving therapy represents a reasonable option for selected patients (100%).

More results

Criteria associated with greater suitability for second breast-conserving therapy included an interval between surgeries of at least 60 months, low-risk accelerated partial breast irradiation classification, luminal molecular profile, and no grade 3 late toxicity related to the first breast-conserving therapy.

“
Conclusion

This international Delphi consensus offers structured guidance for the local management of second iBCE and supports shared decision making and individualised treatment planning.

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