Breast Cancer pp 273-283 | Cite as

Breast Conservation Without Radiation Therapy for Carcinoma of the Breast

  • Gordon F. Schwartz
Part of the Current Clinical Oncology book series (CCO)


The surgical management of carcinoma of the breast has evolved from the Halstedian radical mastectomy of the last millennium through first more radical (extended) and then less formidable (modified) forms of mastectomy, but still using the same adjective, “radical,” in the description of the operation. Dissection of the axilla was truncated from complete dissection of levels I, II, and III, to dissection of levels I and II only. In the last quarter of the last century, following reports of successful clinical trials of radiation therapy as an alternative, mastectomies of all kinds began to be replaced by so-called breast-conserving therapy (BCT), implying local excision of the primary tumor with “clear” margins around it, plus axillary dissection of levels I and II, and then radiation therapy to the entire breast and a boost of radiation to the site of the tumor itself. Despite the obvious difference in the technique and its appearance, the same principles apply for BCT as for mastectomy. Whether removed or radiated, the entire breast is treated, and whether the entire axilla is dissected or merely sampled by sentinel node biopsy, axillary node status is addressed.


Sentinel Node Biopsy Invasive Cancer Local Excision Invasive Lobular Carcinoma Axillary Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bodian CA, Perzin KH, Lattes R (1996) Lobular neoplasia. Long term risk of breast cancer and relation to other factors. Cancer 78, 1024–1034.PubMedCrossRefGoogle Scholar
  2. Gazet J-C, Ford HT, Bland JM, Markopolous CH, Coombes RC, Dixon RC (1988) Prospective randomized trial of tamoxifen versus surgery in elderly patients with breast cancer. Lancet 1, 679–681.PubMedCrossRefGoogle Scholar
  3. Gazet J-C, Ford HT, Coombes RC, et al. (1994) Prospective randomized trial of tamoxifen vs surgery in elderly patients with breast cancer. Eur. i Surg. Oncol. 20, 207–214.Google Scholar
  4. Gazet J-C, Markopoulos C, Ford HT, Coombes RC, Bland JM, Dixon RC (1988) Tamoxifen and breast cancer in the elderly [letter]. Lancet 1, 1218.PubMedCrossRefGoogle Scholar
  5. Gump FE, Kinne DW, Schwartz GF (1998) Current Treatment for Lobular Carcinoma in Situ. Ann. Surg. Oncol. 5, 33–36.PubMedCrossRefGoogle Scholar
  6. Schwartz GF (1993) Treatment considerations in poor-risk patients. In: Ariel IM, Cahan AC (eds.) Treatment of Pre-Cancerous Lesions and Early Breast Cancer. Williams & Wilkins, Baltimore, pp. 295–301.Google Scholar
  7. Schwartz GF (1997) Treatment of sub-clinical ductal carcinoma in situ by local excision and surveillance: a personal experience. In: Silverstein MJ, Lagios MD, Recht A, Pollen DN (eds.) Ductal Carcinoma In Situ of the Breast. Williams & Wilkins, Baltimore, pp. 353–360.Google Scholar
  8. Schwartz GF, Finkel GC, Garcia JC, Patchefsky AS (1992) Sub-clinical duct carcinoma in situ of the breast (DCIS): treatment by local excision and surveillance alone. Cancer 70, 2468–2474.PubMedCrossRefGoogle Scholar
  9. Schwartz GF, Solin LJ, Olivotto IA, Ernster VL, Pressman PI, the Consensus Conference Committee (2000) Consensus Conference on the Treatment of In Situ Ductal Carcinoma of the Breast. Cancer 88, 946–954.PubMedCrossRefGoogle Scholar
  10. Silverstein MJ, Lagios MD, Oroshen S, et al. (1999) The influence of margin width on local control in patients with ductal carcinoma in situ (DCIS) of the breast. N. Engl. J. Med. 340, 1455–1461.PubMedCrossRefGoogle Scholar
  11. Silverstein MJ, Poller DN, Craig PH, et al. (1996) A prognostic index for ductal carcinoma in situ of the breast. Cancer 77, 2267–2274.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Gordon F. Schwartz

There are no affiliations available

Personalised recommendations