, Volume 16, Issue 10, pp 2953-2954
Date: 05 Aug 2009

Magnetic Resonance Imaging and Potential Impact on Extent of Surgery in Breast Cancer

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To the Editors:

Breast-conserving surgery (BCS) is the standard surgical procedure in women diagnosed with early breast cancer. Although the overall rate of local treatment failure is low, local event rates in a long-term period after BCS are alarmingly high for some specific subgroups of patients.

To prevent these local failures in the affected breast [ipsilateral breast cancer recurrence (IBC) or a new tumor] and/or in unaffected breast [contralateral breast cancer (CBC)], a breast cancer patients in the United States are increasingly choosing a more aggressive surgery than the current preferred BCS. The data of the Surveillance, Epidemiology and End Results database show that the rate of contralateral prophylactic mastectomy (CPM) has been increased over the last years. The CPM rate was increased by 150% within 5 years; from 4.2% in 1998 to 11% in 2003. However, this generalization in surgical overtreatment does not reflect an evidence-based approach and may harm patients and society,