If you have local breast cancer recurrence (cancer that comes back in the same area it was originally diagnosed), and your original treatment was lumpectomy and radiation therapy, your doctor may recommend mastectomy. Doctors very seldom recommend having a second lumpectomy to treat local recurrence; it's usually only an option if you've never had radiation before and the risk of the cancer spreading is very, very low.
If breast cancer comes back in a reconstructed breast, your doctor may recommend that the implant or skin flap used to rebuild the breast be removed. It’s possible that at a later time the breast can be fully reconstructed again. You can discuss your options with your medical oncologist and plastic surgeon.
In most cases, after surgery your doctor will recommend radiation and chemotherapy, as well as hormonal therapy and targeted therapies if appropriate for your type of cancer.