[Conservative approach for breast cancer. The experience of the European Institute of Oncology].
Conservative surgery represents the standard care for patients with early breast cancer. The aim of this review was to discuss the extension of conservative surgery in controversial fields such as after primary chemotherapy for large tumours or the possibility to repeat conservative surgery for a local reappearance. The project of a conservative approach to breast cancers continues with sentinel node biopsy which is worldwide performed more and more frequently. In our institute sentinel node biopsy is the standard procedure in the axillary staging of breast cancer even in those clinical scenarios which were previously considered either controversial or a contraindication such as in multicentric breast cancer, during pregnancy, in intra-ductal neoplasias, after primary chemotherapy, and male breast cancer. This conservative approach is completed by the possibility to deliver a partial breast irradiation and to provide patients with more personalized adjuvant treatments tailored on the biological features of the tumour.
Gentilini
O
O
Divisione di Senologia, Istituto Europeo di Oncologia di Milano, Milano. oreste.gentilini@ieo.it
Veronesi
P
P
Gatti
G
G
Intra
M
M
Mazzarol
G
G
Trifirò
G
G
Bassi
F
F
Caliskan
M
M
Da Lima
L
L
Galimberti
V
V
Luini
A
A
D000328:Adult; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000601:surgery*; D002278:Carcinoma in Situ / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D021701:Sentinel Lymph Node Biopsy; D013997:Time Factors