TAILIEUCHUNG - Chapter 086. Breast Cancer (Part 6)

Breast Cancer: Treatment Primary Breast Cancer Breast-conserving treatments, consisting of the removal of the primary tumor by some form of lumpectomy with or without irradiating the breast, result in a survival that is as good as (or slightly superior to) that after extensive surgical procedures, such as mastectomy or modified radical mastectomy, with or without further irradiation. Postlumpectomy breast irradiation greatly reduces the risk of recurrence in the breast. While breast conservation is associated with a possibility of recurrence in the breast, 10-year survival is at least as good as that after more radical surgery. Postoperative radiation to regional nodes following. | Chapter 086. Breast Cancer Part 6 Breast Cancer Treatment Primary Breast Cancer Breast-conserving treatments consisting of the removal of the primary tumor by some form of lumpectomy with or without irradiating the breast result in a survival that is as good as or slightly superior to that after extensive surgical procedures such as mastectomy or modified radical mastectomy with or without further irradiation. Postlumpectomy breast irradiation greatly reduces the risk of recurrence in the breast. While breast conservation is associated with a possibility of recurrence in the breast 10-year survival is at least as good as that after more radical surgery. Postoperative radiation to regional nodes following mastectomy is also associated with an improvement in survival. Since radiation therapy can also reduce the rate of local or regional recurrence it should be strongly considered following mastectomy for women with high-risk primary tumors . T2 in size positive margins positive nodes . At present nearly one-third of women in the United States are managed by lumpectomy. Breast-conserving surgery is not suitable for all patients it is not generally suitable for tumors 5 cm or for smaller tumors if the breast is small for tumors involving the nipple areola complex for tumors with extensive intraductal disease involving multiple quadrants of the breast for women with a history of collagen-vascular disease and for women who either do not have the motivation for breast conservation or do not have convenient access to radiation therapy. However these groups probably do not account for more than one-third of patients who are treated with mastectomy. Thus a great many women still undergo mastectomy who could safely avoid this procedure and probably would if appropriately counseled. An extensive intraductal component is a predictor of recurrence in the breast and so are several clinical variables. Both axillary lymph node involvement and involvement of vascular or lymphatic

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