Abstract

E.A. Sule*

ABSTRACT

The recognized benefit of breast conservation for breast cancer in increasing quality of life and preserving women’s self body image[1] has rendered it a desirable surgical option for the disease. The successes recorded of breast conserving surgery as standard treatment for T1 and T2 tumours following randomized clinical trials has been extended to locally advanced tumours. Even though breast conservation was initiated using T1 and T2 tumours, the experience with T3 and T4 tumours suggest that breast conserving therapy may be applied in these groups of patients with no difference in outcome in comparison to mastectomy.[1] Since the indication for breast conserving surgery has been small tumours, downstaging a hitherto large breast tumour to a lumpectomy amenable size has increased the range of tumours suitable for conservation. Early randomised trials have demonstrated the feasibility of increased breast conservation with the use of neoadjuvant chemotherapy moreso with increased chemosensitivity of the tumours for downstaging to breast conservation volumes.[2] Hence neoadjuvant chemotherapy is considered a standard of care in achieving sufficient tumour downstaging for large breast tumours for breast conservation.[2] Fitzal et al have reported on 196 breast cancer patients with T3 and T4 tumours with no significant difference with mastectomy for overall survival, local recurrence free survival and breast cancer related death.[1]