Abstract: |
The introduction of population-based screening programs has resulted in a shift toward smaller, earlier-stage, localized tumors, most of which are suitable for BCT. The results of this meta-analysis should not be interpreted as an indication that breast conservation is inferior to mastectomy, but rather a reminder that appropriate patient selection, attention to detail, optimal surgical technique, and radiotherapy where appropriate are critical elements in minimizing local relapse and mortality from breast cancer. While we await results from ongoing efforts to clearly define both the suitability of BCT in highrisk groups and the indications for postmastectomy radiotherapy, the EBCTCG has provided physicians with clear evidence that in addition to early diagnosis, breast cancer mortality is affected by variations in local control. As surgeons, we are heartened that this analysis has finally con.rmed that local control truly does matter. © 2007 Society of Surgical Oncology. |