Conservation surgery and radiation therapy in early breast cancer - An update

Background Multiple randomised trials and metaanalyses have supported the use of conservative surgery (CS) and radiation therapy (RT) for the treatment of early-stage breast cancer. Following lumpectomy, RT has been shown to decrease the chance of local recurrence and improve overall survival when compared with lumpectomy alone. Objectives This update outlines the rationale and outcomes for CS and RT, whether a subgroup exists in which RT may be safely omitted, the process of RT, common side effects and their management, and the latest techniques in the field. Discussion Breast conservation remains an effective treatment for breast cancer without a survival disadvantage to a mastectomy. The combination of advanced imaging and fast three-dimensional (3D) radiotherapy planning computer systems have allowed new techniques that deliver RT more accurately, with better tumour control, fewer side effects and improved survival.