title: Function-preserving surgery for breast cancer.
abstract: Breast-conserving treatment is well established as a safe method of treatment for the majority of breast cancers. Issues to be addressed concerning breast-conserving treatment include the omission of radiation therapy in low-risk patients, optimal local and systemic treatment for ipsilateral breast tumor recurrence, classification of ipsilateral breast tumor recurrence into true recurrences and new primary cancers, and the selection of patients who are eligible for breast conservation after neoadjuvant chemotherapy. There is much evidence that sentinel node biopsy is an accurate method of screening for axillary nodal status in patients with early breast cancer. Clearly, the avoidance of axillary dissection improves quality of life. The feasibility, accuracy, and timing of sentinel node biopsy in patients undergoing neoadjuvant chemotherapy are not yet clear. Also, the clinical significance of micrometastasis should be evaluated to determine the optimal application of sentinel node biopsy. There is interest in replacing breast-conserving treatment by nonsurgical ablation, although additional findings are needed to show that this technique is a true advance in breast cancer treatment.
authors.affiliation: Department of Breast Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan. inaji-hi@mc.pref.osaka.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Inaji
authors.forename: Chiyomi
authors.initials: C
authors.lastname: Egawa
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Komoike
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Motomura
authors.forename: Kinji
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Tatsuki R
authors.initials: TR
authors.lastname: Kataoka
authors.forename: Hiroki
authors.initials: H
authors.lastname: Koyama
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D003452:Cryosurgery / Q000379:methods; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental / Q000379:methods; D008872:Microwaves / Q000627:therapeutic use; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011788:Quality of Life; D021701:Sentinel Lymph Node Biopsy