Breast Conservation Without Radiation Therapy for Carcinoma of the Breast
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.
KeywordsSentinel Node Biopsy Invasive Cancer Local Excision Invasive Lobular Carcinoma Axillary Dissection
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- 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
- 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
- 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