Breast cancer: A 21 year experience with conservative surgery and radiation

Targeted intraoperative radiotherapy versus whole breast radiotherapy for breast cancer (TARGIT-A trial): an international, prospective, randomised, non-inferiority phase 3 trial

“…Many observational studies and randomised clinical trials have shown that more than 90% of recurrent disease occurring in the breast is within the index quadrant, [5][6][7][8][9][10][11][12][13] which is by contrast with the fi ndings of three-dimensional analysis of mastectomy specimens that show that 63% of breasts harbour occult cancer foci, with 80% of these situated remote from the index quadrant. [14][15][16] These widespread and occult multifocal or multicentric cancers in other quadrants of the breast therefore appear to remain dormant for many years or even decades, and have a low risk of causing clinical tumours.…”

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

“…2,[21][22][23][24][25][26][27][28][29][30] At ten years, overall survival has ranged from 67 to 88 percent depending upon the stage of the disease ( control within the treated breast with primary tumors less than or equal to 5 cm in diameter (Table 7). 1,2,[22][23][24]27,28,[31][32][33][34][35][36][37][38] At ten years, local recurrence rates range from 8 to 19 percent. For patients with negative margins of resection, the ten-year actuarial risk of breast recurrence is 10 percent or less.…”

“…Clark et al 35 1, 130 5 14 Mansfield et al 24 1 In every instance, when one abnormality is seen, all areas of each breast should be fully evaluated for the presence of additional disease. Some studies have suggested that magnetic resonance imaging (MRI) is a useful adjunct to mammography and ultrasound for the identification of multifocal and multicentric disease.…”

Long-term prognosis of patients with local recurrence after conservative surgery and radiotherapy for early breast cancer

“…Earlier studies reported 5-year survival rates ranging from 70% to 84% after salvage treatment for patients with local recurrence after BCT, which is equal or only slightly worse compared with those without local recurrence [5,[11][12][13]. More recent series, however, reported poorer 5-year survival rates, ranging from 55% to 68% after 5 years [3,14] and one study even reached the conclusion that the survival after treatment for an early loco-regional recurrence after modified radical mastectomy or BCT is similar [15].…”