title: Less Is More: The Evolving Surgical Approach to Breast Cancer.
abstract: Personalized medicine is emerging as an important guiding principle in diagnosis and treatment. This means not just doing more for some, but safely doing less for others. The lessons learned about the biology of breast cancer over the last 2 decades have enabled us to understand the incredible heterogeneity of breast cancer and its associated behavior. Although much work remains, there is an emerging opportunity to identify and recognize more indolent forms of breast cancer, made more prevalent through the widespread adoption of screening. With our improving systemic therapies and improved molecular tools, we now have the opportunity to reduce the burden of treatment in women with lower-risk tumors. Our surgical treatments have evolved, with less morbid and more cosmetic procedures. In this article, we review the indications for further reducing local therapy, including adjuvant radiation.
authors.affiliation: From the University of California, San Francisco, San Francisco, CA.
authors.forename: Laura
authors.initials: L
authors.lastname: Esserman
authors.affiliation: From the University of California, San Francisco, San Francisco, CA.
authors.forename: Etienne
authors.initials: E
authors.lastname: Gallant
authors.affiliation: From the University of California, San Francisco, San Francisco, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Alvarado
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009367:Neoplasm Staging; D057285:Precision Medicine; D018714:Radiotherapy, Adjuvant