Currently, BC is classified into five different molecular subtypes [26], [27] and [28] according to immunohistochemical (IHC) classification: • Luminal A (characterized by hormone receptors (HR)-positive tumor cells and low Ki-67 expression; human epithelial growth factor receptor 2 (HER2)-negative status) The hazard rates for relapse among HR-negative and/or non-luminal A tumors show a sharp peak soon after

initial diagnosis. Conversely, hazard rates for HR-positive and luminal A tumors are persisting low over the time [25]. A recent analysis showed that patients with Luminal B breast cancer had a continuously higher hazard of breast cancer recurrence over time and a shorter OS compared with Luminal A patients [29] and [30]. Moreover, Luminal B patients had higher rates of bone as first recurrence site than other subtypes. Visceral recurrence as first event was similar among Luminal Vincristine B, HER2 enriched and triple negative BC. From a biological BGB324 purchase point of view, the observation of different patterns of relapse suggests different mechanisms involved in early and late BC events. As a consequence, it is tempting to hypothesize that schedule and intensity of surveillance should vary accordingly. The survival of women suffering locoregional recurrence is markedly different compared to those suffering distant metastases (80% 5-year relative survival rate versus 25% 5-year relative survival rate, respectively) [31] and patients with

isolated locoregional or contralateral breast cancer recurrences detected without symptoms have a better survival compared to patients in whom a late symptomatic detection is performed. Over the last two decades, it has been demonstrated that patients with solitary first locoregional recurrence after mastectomy may achieve a 5-year DFS rate of 61–79% if they underwent a radical locoregional treatment combined with systemic

adjuvant therapy [32] and [33]. Unfortunately, the first site of relapse is represented by local recurrence in only one-third of recurrent BC patients [34]. Even if some retrospective analyses suggested that having an inflammatory BC at the primary diagnosis [35] as well as the tumor stage and pathological nodal stage after neoadjuvant treatment [36] may predict for a higher risk of locoregional recurrence, no strategy are current available to identify patients Thalidomide who are more likely to have a local relapse. The detection of isolated locoregional and contralateral recurrence or new breast primary in asymptomatic patients by mammography leads to an absolute reduction in mortality of 17–28% [37]. Nevertheless, surveillance mammography is affected by both false-negative (approximately 10% of palpable tumors are not clearly visible on mammography) and false-positive results, which require further investigations, especially when deleterious changes in breast tissue have been induced by surgery and radiotherapy [38], [39] and [40].