Benefits versus risks in conservation surgery with irradiation for breast cancer

This report analyzes the survival and complications inherent in the conventional treatment of breast cancer, radical mastectomy, and the more conservative procedure, conservation surgery with irradiation. Both procedures have benefits and risks. The benefits as measured by survivorship appear to be approximately the same. The major benefit of conservation surgery with irradiation is that the breast is left intact. The possible complication of irradiation carcinogenesis is addressed, and the literature analyzed. This review indicates that the absolute risk of breast cancer developing in the second breast is not nearly as great as originally thought. It is concluded that if a woman with breast cancer is a candidate for either mastectomy or the conservative procedure, it is the clinician's obligation to objectively present the evidence regarding the benefits and risks of these procedures.