Early Breast Cancer

  • BBSG – Brazilian Breast Study Group


The increase in the number of women undergoing mammography annually allows for the diagnosis in the early stages. It is estimated that in 2020, 25% of the breast tumors diagnosed in Brazil are smaller than 2 cm. Breast cancer is divided into three groups, which will guide behaviors and prognosis: early, locally advanced, and metastatic breast cancer. According to the American Joint Committee on Cancer (AJCC), locally advanced carcinoma comprises stages IIIA, IIIB, and IIIC, i.e., tumors with extensive lymph node involvement (N2 and N3) or chest wall invasion (T4a), skin (T4b), or both.


Early breast cancer Breast-conserving surgery Mastectomy Sentinel node biopsy Systemic treatment Radiation therapy 

Recommended Reading

  1. 1.
    Aebi S, Davidson T, et al. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2011;22(Supplement 6):vi12–24. Breast cancer treatment protocols recommended by the European Oncology Society according to the level of evidence and degree of recommendation. CrossRefGoogle Scholar
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    De Felice C, Cipolla V, Stagnitti A, Marini A, Pasqualitto E, Meggiorini ML. The impact of presurgical magnetic resonance in early breast cancer: an observational study. Eur J Gynaecol Oncol. 2012;33(2):193–9. 123 patients with a diagnosis of invasive, unilateral and unifocal carcinoma, with indication of conservative surgery, were submitted to preoperative magnetic resonance imaging. In 34.2% of the cases, MRI findings led to surgery with a greater extension, and in 4.2% of the cases, the finding through MRI was not confirmed in the anatomopathological study (over-treatment). It concludes that in selected patients, MRI seems to be important in surgical planning. PubMedGoogle Scholar
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    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG). Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10.801 women in 17 randomised trials. Lancet. 2011;378(9804):1707–16. Analysis of these studies has shown that radiotherapy after conservative breast surgery not only reduces the risk of local recurrence but it also reduces the risk of death from breast cancer. CrossRefGoogle Scholar
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    Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Peto R, Davies C, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials. Lancet. 2012;379(9814):432–44. These studies showed a 1/3 survival gain in 10 years, regardless of the type of chemotherapy used. Patients with low risk of death had low benefit if they used chemotherapy. The authors suggest that the results of genetic marker exams and quantitative immunohistochemistry may aid in predicting risk and responding to chemotherapy. CrossRefGoogle Scholar
  5. 5.
    Garcia-Etienne CA, Tomatis M, et al. Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database. Eur J Cancer. 2012;48:1947–56. 13,569 patients 13 European centers for the treatment of breast cancer were evaluated between 2003 and 2010. Conservative surgery was performed in 73.3% of the cases. Annual statistical analyzes were performed, with a reduction of 4.24% per year in mastectomy indications. CrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • BBSG – Brazilian Breast Study Group
    • 1
  1. 1.BBSGSao PauloBrazil

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