Info
Local management with surgery and radiation-of-localized breast cancer
- Mastectomy = lumpectomy + RT in OS (NEJM 2002;347:1227)
- SLNB
- ALND
- RT: No OS for RT after BCS for pts >70 yo, ER+, & node (−) (CALGB 9343, JCO 2013;31:2382)
- Post mastectomy RT
- Consider addition of regional nodal irradiation to whole-breast irradiation after BCS if pos. LN (NEJM 2015;373:307; NEJM 2015;373:317)
General (neo)adjuvant principles
- Aims: ↓ recurrence risk & ↑ survival, NAC ∼ adj. (JCO 2008;26:778)
- aims of NAC in breast cancer
- Recurrence:
- TNBC, HER2+ mostly in 1st 3-5 y.
- ER+ steady risk 0-14 y
- Isolated local recurrence:
- Tx decision case-by-case;
- chemo benefit limited to ER-neg dz (CALOR, Lancet Onc 2014;15:156)
Siblings
- Local management with surgery and radiation-of-localized breast cancer
- Chemotherapy regimens for NAV or ADJ use in HR positive and TNBC-of-localized breast cancer
- Hormone positive disease-adjuvant endocrine treatment
- Hormone-positive disease-neoadjuvant therapy-of-localized breast cancer
- HER2-positive disease-of-localized breast cancer
- Considerations for young patients-of-localized breast cancer