Management of breast cancer

The aims of local management are to:

• remove the local tumour reducing local growth
• eliminate the risk of this deposit seeding distant sites
• provide an aesthetic result

There has been a tendency to move away from radical operations to breast conservation. This has resulted from a realisation that prognosis is not altered greatly by more extensive excisions yet morbidity is increased. Some key papers comparing mastectomy against conservative treatment are detailed in the submenu.

Equally, for conservative surgery there has been a realisation that adjuvant radiotherapy to the breast is a necessity. Local recurrence rates of up to a third at 8 years occur in simple excision without radiotherapy. The rates with radiotherapy are between 10 and 20%.

Management of disease in the breast must be combined with a consideration of management of:

• axillary disease
• distant metastases

This is dealt with in the main menu.