Avoiding a mastectomy after a local recurrence:
Second lumpectomy + TARGIT-IORT in cases of local recurrence after EBRT

Various groups have published outcomes of series of patients who had a local recurrence after breast conserving surgery (lumpectomy) + whole breast external beam radiotherapy (EBRT) with or without tumour bed boost.
These patients could preserve their breasts, as per their wish, by having a wide local excision (lumpectomy) plus TARGIT-IORT.
The studies found that this was a safe and effective approach.
The papers are listed below:

2007-09-14 Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapy  
BMC Cancer
Germany https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-7-178

2011-05-01 Targeted intraoperative radiotherapy for breast cancer in patients in whom external beam radiation is not possible
International Journal of Radiation Oncology Biology Physics
UK and Worldwide https://www.redjournal.org/article/S0360-3016(10)00145-8/abstract

2011-06-21 Intraoperative radiotherapy during a second breast-conserving procedure for relapsed breast cancer after previous external beam radiotherapy.
International Journal of Radiation Oncology Biology Physics
Germany https://www.redjournal.org/article/S0360-3016(11)00358-0/fulltext

2018-01-15 Breast conserving surgery in combination with intraoperative radiotherapy after previous external beam therapy: an option to avoid mastectomy
Breast Cancer Research and Treatment
Germany  https://link.springer.com/article/10.1007%2Fs10549-017-4657-y 

2022-06-02  Breast preservation after local recurrence of breast cancer: Comparison of length and quality of life (QoL) between breast conserving surgery with intraoperative radiotherapy (TARGIT-IORT) versus mastectomy.
Journal of Clinical Oncology
Germany https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.e12573    

2022-06-21 Breast preservation after in-breast-recurrence of breast cancer: comparison of overall survival and quality of life (QoL) between breast conserving surgery with intraoperative radiotherapy (TARGIT-IORT) versus mastectomy 
Senologie Zeitschrift für Mammadiagnostik und therapie
Germany https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0042-1748415 

​2023-02-01 Breast Conserving Surgery in Combination With Targeted Intraoperative Radiotherapy Compared to Mastectomy for In-breast-tumor-recurrence        
Anticancer Research
Germany https://ar.iiarjournals.org/content/43/2/733.abstract

2023-05-09 Can breast cancer be reirradiated? 
Revista de Senología y Patología Mamaria - Journal of Breast Science 
Spain https://www.sciencedirect.com/science/article/abs/pii/S0214158223000270