在早期浸润性乳腺癌中使用初次全身治疗 (PST) 是常规治疗，但人们担心局部区域复发的风险。我们进行了系统性文献综述，以确定接受非治疗的早期浸润性乳腺癌患者的局部区域治疗和复发的研究。 -内分泌 PST。我们确定了 112 项研究（18 项前瞻性试验和 94 项非干预性研究）。分别有 65 项 (58%) 和 50 项 (45%) 研究记录了 PST 后使用手术和放疗的情况。 66 项 (59%) 研究报告了局部复发。累积 5 年局部复发风险从 1% 到 23% 不等。 40岁以下患者、PST后未达到病理完全缓解、ER阴性或HER2阴性肿瘤、PST前记录为无法手术的疾病、未接受放疗的患者局部区域复发率较高。这些研究中的 LRR 率在患者入组的整个日历期间（1999-2016）并未下降。在 PST 研究中，局部治疗和结果的记录并不理想，需要努力改进这一点。在缺乏随机证据的情况下，我们的研究结果可能有助于为护理和指南的制定提供信息。我们无法排除使用 PST 与局部复发风险高于预期相关的担忧。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

The use of primary systemic therapy (PST) in early invasive breast cancer is routine but there are concerns about risk of locoregional recurrence.We conducted a systematic literature review to identify studies of locoregional treatment and recurrence in patients with early invasive breast cancer who received non-endocrine PST.We identified 112 studies (18 prospective trials and 94 non-interventional studies). The use of surgery and radiotherapy after PST was recorded in 65 (58 %) and 50 (45 %) of studies respectively. 66 (59 %) studies reported locoregional recurrence. Cumulative 5-year locoregional recurrence risks varied from 1 % to 23 %. Locoregional recurrence was higher in patients under the age of 40, those who did not achieve a pathological complete remission after PST, had ER-negative or HER2 negative tumours, were recorded to have inoperable disease before PST, and did not have radiotherapy. LRR rates in these studies have not fallen over the overall calendar period of patient enrollment (1999-2016).The recording of locoregional treatments and outcomes is suboptimal in studies of PST and efforts to improve this are required. In the absence of randomised evidence, our findings may help to inform care and guideline development. We were unable to exclude concern that the use of PST is associated with a higher than desired risk of locoregional recurrence.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.