Abstract
How much can improved molecular and pathologic discriminants change local therapy?
Highlights
How accurately the extent of disease is assessed with currently available tools can be evaluated by examining mastectomy rates in patients who are initially selected for BCT and the use of re-excision to obtain negative margins in patients undergoing BCT
This study indicates that patients with hormone receptor positive tumours treated with appropriate endocrine therapy have extremely low rates of local recurrence
It is likely that similar results will be seen for human epidermal growth factor receptor (HER)-2-positive patients treated with adjuvant trastuzumab, because the randomized trials of adjuvant trastuzumab revealed an approximately 50% reduction in locoregional recurrence with trastuzumab treatment compared with treatment with chemotherapy alone [13]
Summary
How accurately the extent of disease is assessed with currently available tools can be evaluated by examining mastectomy rates in patients who are initially selected for BCT and the use of re-excision to obtain negative margins in patients undergoing BCT. A metaanalysis of 19 studies involving 2,763 breast cancer patients revealed that MRI detected additional disease in 16% (range 6% to 34%) that led to more extensive surgical therapy [5].
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