Conservation Therapy of the Breast: Optimizing Long-term Results

BACKGROUND: Radiation therapy is a key component of breast conservation therapy for breast cancer. There is great interest in safety and long-term outcome issues for this still underutilized approach. METHODS: The author reviews a series of factors that may affect the end results of conservation therapy and highlights those that are likely to be of clinical significance. RESULTS: Daily dose fractions are usually less than 2 Gy and a homogeneous whole-breast dose is used. Care is needed with patients with collagen vascular diseases, large breasts, breast trauma, and prior infections, but these factors are not absolute contraindications to breast conservation therapy. Acute skin reactions are not predictive of long-term complications. CONCLUSIONS: With adherence to proper surgical and radiation techniques, most patients presenting with localized breast cancer can be managed safely and effectively with breast conservation.