Abstract Through careful study, we are certain of the management necessary to achieve excellent local regional control rates in early stage breast cancer (ESBC). Due to less study, there is some uncertainty on how to best manage the small percentage of women with ESBC who have local regional recurrences (LRR). Classically, the management of LRR requires some form of salvage surgery. The surgery could be limited, as in wide local excision after initial mastectomy, or more radical, as in mastectomy after initial breast conserving therapy. Often after salvage surgery, radiation, or in some cases re-irradiation, is added. Today there is information which calls into question whether these common treatments for LRR are required, sufficient or the sole options. During this session, we will review the data supporting these common treatments for LRR, as well as alternatives such as surgery alone, partial breast re-irradiation, photodynamic therapy and hyperthermia. After the presentation, the attendee will have a greater understanding of the various local therapy options for treating LRR of breast cancer and the need for prospective study of this small but significant group of patients. Citation Format: Zellars RC. Local regional recurrence [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr ES7-2.