What is your systemic therapy approach to women with isolated local recurrences of hormone-receptor positive breast cancer?

I will assume this case involves a chest wall or other local recurrence. In this case, it depends on whether the tumor is resectable. Based on the CALOR trial, wide resection, XRT (if not previously done), and anti-hormonal therapy would be the way to go. I would probably try to add a CDK4/6 inhibitor in this setting as well, since technically the patient would have stage IV NED disease.

If unresectable, I would give an anti-hormonal therapy with a CDK 4/6 inhibitor, and possibly try to resect if...