RESUMO
Approximately 80 percent of women with breast cancer are candidates for breast conservation, but national statistics suggest that more than half of the women treated in the United States of America continue to be treated with mastectomy. This therapeutic option is grossly underutilized in the West Indies. The results of many large scale multi-institutional clinical trials have demonstrated the equivalence of "Breast Conserving Therapy" (conservative surgery and post operative radiation) with mastectomy. The aim of the conservative approach is to eradicate disease, reduce local recurrence at the primary site with minimal complications, and without a negative impact on quality of life or survival, while achieving acceptable cosmesis. Factors influencing patient selection, recent clinical trials, optimal surgical and radiation techniques and potential morbidity associated with breast conservation therapy will be discussed. Adjuvant therapy (cytotoxic chemotherapy and/or hormone therapy), recommendations for follow up care and the management of complications and recurrence will be reviewed.(AU)
