Would you consider whole breast re-irradiation in a patient with a second/recurrent breast cancer and prior history of breast radiation therapy many years ago, if the tumor characteristics are not amenable to partial breast re-irradiation?  

A second lumpectomy after recurrence post-lumpectomy/RT in itself makes it amenable to APBI, i.e., the pathology or clinical factors do not matter after a 2nd lumpectomy. Since the early literature (from UPMC) to more recent prospective trials (RTOG 1014), the CTV is the lump cavity, regardless of o...