, Volume 16, Issue 3, pp 783-784
Date: 05 Sep 2008

Exploring Clinical Implications of Mechanisms for Breast Cancer Local Recurrence

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To the Editors

Breast-conserving treatment is the standard treatment for stage I and II breast cancer.1 Although 5-year survival results show an overall low recurrence rate, longer follow-up reveals that this rate is significant, and in particular subgroups this local failure is substantial.24 Latest data from phase III randomized trials have demonstrated that local recurrence and contralateral breast cancer are likely to be the first and isolated events reducing the overall survival.5

To prevent both of these local failures and improve survival, a trend toward aggressive surgery is recently occurred in the USA.6 However, bilateral mastectomy may harm low-risk patients undergoing this unnecessary overtreatment. This aggressive surgery may benefit only high-risk patients.7 A subset of these high-risk individual women can be predicted on the basis of established clinicopathologic risk factors,8 latest results on the impact of modern adjuvant treatment including endocrine therapy and trast ...