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Goals of medical management

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The outcome of treatment is likely to depend on the stage at which the breast cancer presents.

Stage I and II disease (ie local nodal involvement, but nodes not fixed), accounts for about 80% of breast cancer. It may be regarded as "curable." Local control is by wide local excision (WLE) with axillary node dissection and radiotherapy, or by simple mastectomy. Modified radical mastectomy is now, only occasionally advised. Chemotherapy and/or hormonal therapy may be used for systemic control.

For stage III and IV (ie locally advanced disease or distant metastasis), the goals of treatment are to control local disease and to improve the quality of life. Most die of distant metastases. Surgery is tailored to the individual, and is limited to "salvage" mastectomy. Chemotherapy and radiotherapy are the dominant treatment modalities.


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