Abstract
Rates of local tumour relapse after breast conservation treatment in women with early
breast cancer are falling. Explanations for this decline are considered in this review
including advances in breast cancer management and aging of the breast cancer population.
Breast surgery has become more standardised following publication of practice guidelines
and is mostly carried out by specialist surgeons. Systemic therapies (hormonal therapy
and chemotherapy) are now more effective and are recommended to a higher proportion
of patients than ever before. Radiotherapy techniques have also improved. The contributions
of each factor are difficult to quantify precisely, but all are likely to be relevant.
In order to identify a subgroup of women that might safely be spared radiotherapy,
several factors are analysed, including the prognostic significance for local relapse
of tumour characteristics (pathologic data, gene-expression profiles), patient characteristics
and life expectancy (age and comorbidities).
Keywords
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Article info
Publication history
Published online: May 27, 2008
Accepted:
May 1,
2008
Received:
March 10,
2008
Identification
Copyright
© 2009 Published by Elsevier Inc.
