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Whole-Breast Radiotherapy After Breast-Conserving Surgery

  • Lior Z. BraunsteinEmail author
Chapter

Abstract

Oncologic advances and the emergence of precision medicine have made organ preservation increasingly achievable in the definitive management of various cancers. Breast-conserving therapy (BCT) is one such paradigm that has emerged from sequential efforts in the basic, clinical, and translational domains. Since the Halstedian era of increasingly aggressive surgical resection, investigators have sought to employ wide-ranging innovations to improve outcomes while simultaneously mitigating the toxicities of curative treatment. Enhanced radiographic techniques, meticulous attention to surgical margins, improvements in systemic therapy, and revolutionary radiation approaches have all converged to supplant the necessity of mastectomy in many cases of early, localized breast cancer. Indeed, while breast-conserving surgery followed by adjuvant whole-breast radiation now portends outcomes similar to mastectomy in most cases, emerging populations may safely omit adjuvant therapy entirely. Thus, whereas breast cancer was historically managed with the radical mastectomy, limited surgical resection and well-tolerated adjuvant treatments now portend among the best outcomes of any disease in the sphere of oncology. Here, we discuss appropriate selection of patients for BCT and elaborate on the necessary considerations for success of this treatment approach.

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© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologyMemorial Sloan Kettering Cancer CenterNew YorkUSA

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