Contraindications for a breast conservative surgery include all except
Patients who desire breast-conserving surgery must be willing to attend postoperative radiation therapy sessions and to undergo postoperative surveillance of the treated breast. A significant factor in determining whether breast-conserving therapy is feasible is the relationship between tumor size and breast size. In general, the tumor must be small enough in relation to the breast size so that the tumor can be resected with adequate margins and acceptable cosmesisContraindications for BCT requiring radiation therapy include the following:Absolute:Radiation therapy during pregnancyDiffuse suspicious or malignant-appearing microcalcificationsWidespread disease that cannot be incorporated by local excision through a single incision that achieves negative margins with a satisfactory cosmetic resultPositive pathologic marginRelative:Active connective tissue disease involving the skin (especially scleroderma and lupus)Tumors >5 cmFocally positive marginWomen with a known or suspected genetic predisposition to breast cancer:May have an increased risk of ipsilateral breast recurrence or contralateral breast cancer with BCTProphylactic bilateral mastectomy for risk reduction may be consideredRef: Sabiston, 20e, page: 846
Diffuse suspicious microcalcifications
Known genetic predisposition
Tumor > 5cm
Age > 50 years
Endocrinology and breast