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Feature Article

Management of early breast cancer

Yoon-Sim Yap, Bogda Koczwara

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Abstract

Sentinel lymph node biopsy, postmastectomy radiotherapy and the use of newer agents such as taxanes and aromatase inhibitors are recent advances in the management of early breast cancer.

Key Points

  • Early breast cancer is potentially curable and, therefore, prompt diagnosis and treatment are crucial.
  • Surgery is the definitive treatment, but a combination of radiotherapy and adjuvant systemic therapy is often used to reduce the risk of local and systemic recurrence and improve the cure rate.
  • Almost all women undergoing partial mastectomy should have postoperative radiotherapy.
  • Adjuvant systemic therapy consists of hormonal therapy (and chemotherapy if high risk tumours) for women with hormone responsive tumours and chemotherapy alone for women with hormone unresponsive tumours.
  • Decisions regarding the best combinations of local and systemic therapies for a patient requires close collaboration between breast surgeon, medical oncologist and radiation oncologist, with input from the patient regarding her preferences in light of the risks and benefits of treatment.
  • Supportive care reduces the impact of treatment side effects and improves the quality of life of women undergoing treatment for early breast cancer.

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