Breast Conservation Safety for Multiple-Site Tumors

Core Concepts

Breast conservation therapy is safe and effective for women with multiple breast tumors.

Abstract

The study presented at the International Conference on Surgical Cancer Care (SSO 2023) and published in the Journal of Clinical Oncology (JCO) highlights the safety and efficacy of breast conservation therapy for women with two or three sites of breast cancer. Key points include:

• Study shows low recurrence risk with breast conservation therapy and radiation.
• Previous randomized trials excluded patients with multiple-site disease.
• New evidence supports breast conservation for women with multiple ipsilateral breast cancers.
• High survival rates and low local recurrence rates observed.
• Ideal candidates have small tumor sizes and suitable breast size for multiple excisions.
• Study details the ACOSOG (Alliance) Z11102 trial with positive outcomes.
• Patients reported good cosmetic outcomes and high adherence to radiation therapy.
• Preoperative breast MRI may impact local recurrence rates.
• Majority of eligible patients prefer breast conservation over mastectomy.

Stats

The rate of cancer local recurrence was 3.1%.
14 patients converted to mastectomy due to positive margins.
70.6% of patients reported good or excellent cosmetic outcomes at 2 years.
5-year rate of local recurrence was significantly higher at 22.6% among patients without preoperative MRI.

Quotes

"I am excited about these findings because it will empower patients and the multidisciplinary care teams caring for patients to be thinking about this option for women who may want to preserve their breast." - Judy Boughey, MD

Key Insights Distilled From

Breast Conservation Safe Even With Multiple-Site Tumors

by Nancy A. Mel... at www.medscape.com 03-28-2023

https://www.medscape.com/viewarticle/990177

Deeper Inquiries

How can the findings of this study impact the current treatment guidelines for breast cancer?

The findings of this study can have a significant impact on current treatment guidelines for breast cancer by providing evidence that breast conservation therapy is a safe and effective option for women with multiple breast tumors. This study demonstrates that the oncologic safety of breast conservation in these patients is comparable to that of mastectomy, with low rates of local recurrence and high survival rates. As a result, these findings may lead to a shift in treatment guidelines towards recommending breast conservation therapy as a viable option for women with multiple breast tumors, where previously mastectomy was often the preferred approach.

What are the potential drawbacks or limitations of breast conservation therapy for women with multiple breast tumors?

While breast conservation therapy has been shown to be a safe and effective option for women with multiple breast tumors, there are potential drawbacks and limitations to consider. One limitation is the need for careful patient selection, as not all women with multiple breast tumors may be suitable candidates for breast conservation therapy. Factors such as tumor size, tumor location, and breast size can impact the feasibility and success of breast conservation therapy. Additionally, there is a risk of positive margins leading to the need for conversion to mastectomy, which can impact patient outcomes and satisfaction. Furthermore, the cosmetic outcomes of breast conservation therapy may vary, and some women may still prefer mastectomy for personal or psychological reasons.

How can patient education and awareness be improved regarding the choice between breast conservation and mastectomy?

Patient education and awareness regarding the choice between breast conservation and mastectomy can be improved through comprehensive and personalized communication between healthcare providers and patients. It is essential for healthcare providers to discuss the benefits, risks, and potential outcomes of both treatment options with patients, taking into account their individual preferences and values. Providing clear and understandable information about the differences between breast conservation and mastectomy, including cosmetic outcomes, recovery time, and long-term implications, can help patients make informed decisions. Additionally, utilizing decision aids, support groups, and educational materials can empower patients to actively participate in the decision-making process and feel confident in their choice of treatment. Ongoing communication and support throughout the treatment journey can also enhance patient satisfaction and overall outcomes.