Young breast cancer patients who chose lumpectomies need indefinite...( ey choose conservation treatment. Howev...),Health

ey choose conservation treatment. However, this higher risk does not decrease the probabilities of long-term cure, as overall survival is the same, independently of the initial surgery performed. Indeed, local recurrence after breast-conserving surgery may be successfully treated if there is early diagnosis."

He said that a cautious approach should be taken for younger women wider margins to the lumpectomy, the placing of surgical clips in the tumour bed to improve the accuracy of radiotherapy, a good radiotherapy boost technique and the addition of tamoxifen in patients with hormone-responsive tumours. The European Organisation for Research and Treatment of Cancer (EORTC) was, he added, currently planning a new trial to evaluate the role of higher boost doses in younger patients.

Dr Arriagada stressed that the findings did not indicate that young patients should opt for mastectomy. "We should not forget that the increased risk after 15 years is limited 20 to 25%. If a young patient of 35 is able to conserve an aesthetic breast for this time maybe the impact on her quality of life will be a little bit less at 55 years, and in any case three women out of four will be free of local recurrence. This information should be given to patients to enable them to choose between breast conserving surgery and mastectomy with breast reconstruction. We should also be aware that recent developments in genomic techniques could in the future allow the risk of local recurrence among these younger women to be defined more accurately."

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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-153-677-2181
European Society for Medical Oncology
2-Nov-2003

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