EDITORIAL Breast-Conserving Treatment for Breast Cancer: Rational, Current Reality & Limitations

Recently published 20-years follow-up scientific data confirm that there is no difference in survival after breast conservation therapy or total mastectomy in women with stage I or II breast cancer. However, breast conservation treatment is associated with an increased risk of both positive margins and local recurrence. Current estimates suggest that 10 to 20 % of women after breast-conserving treatment is at high-risk of local failures. This is a characteristic example of limitations and lack of generalizability of randomized controlled trials, although they provide the best available evidence for treatment decision-making. ost of the 20th century the Halsted radical mastectomy and during the last decades the modified total mastectomy, were the standardized operation for cancer of the breast in all stages, early or late. However, with advances in the understanding of breast cancer spread mechanisms a new concept towards a less radical surgery1 has bee