title: Criteria and procedures for breast conserving surgery.
abstract: OBJECTIVE
  Emphasizing circumstances that determine increasingly popular surgical approach of breast conserving surgery (BCS), used in lower grade breast tumors, while maintaining survival that is found when more radical procedures are used.
  
  
  METHODS
  Several leading oncological protocols in the world are compared, using PubMed database, and our own experience. Data gathered are compared to conclusions of Consensus Conference on Breast Conservation (Milan, 2005). Furthermore, surgical contraindications found in our everyday work are considered, having in mind satisfactory cosmetic outcome, as well as keeping the 1 cm border of "clear" edges. Such more practical problems of edge detection can compromise BCS results.
  
  
  RESULTS
  After observing several relevant protocols, we found very high frequency of mastectomy vs. BCS, despite the fact that stage of disease was low. We also found only 20% of absolute contraindications for BCS. Most frequent contraindication for BCS was multicentricity of the tumor (with micro calcifications), especially in ductal in situ carcinoma.
  
  
  CONCLUSIONS
  BCS followed by radiation therapy with tumor-free edges is standard procedure in treatment of T1 and small T2 breast cancers. This approach implies higher risk of local recurrence (LR), although local recurrence is low (1% per year), with rates of survival similar to radical procedures.
authors.affiliation: Department of surgery, County hospital , Pozega , Croatia.
authors.forename: Josip
authors.initials: J
authors.lastname: Fajdic
authors.forename: Drazen
authors.initials: D
authors.lastname: Djurovic
authors.forename: Nikola
authors.initials: N
authors.lastname: Gotovac
authors.forename: Zlatko
authors.initials: Z
authors.lastname: Hrgovic
keywords: breast conserving; mastectomy; medical contraindication; surgery