Breast conservation surgery for breast cancer is indicated in which one of the following conditions?
Indications for breast conserving surgery : 1. Patient's desire for breast conservation 2. Tumor less than 4 cm in size (T1 or T2) 3. Good Breast vs. tumor volume ratio 4. Availability of radiotherapy and mammographic facilities 5. Patients with N0 or N1 axillary nodes 6. Non-pendulous breast to allow a uniform radiation dosage distribution Contraindications for BCS: 1. Multicentric breast cancer 2. Diffuse malignant looking micro calcifications on mammogram 3. Matted (N2) axillary lymph nodes 4. Recurrence in a previously conserved breast 5. Collagen vascular disease 6. Early pregnancy 7. H/o previous irradiation to chest wall 8. Positive surgical margins Relative Contraindications for BCS: 1. Tumor size >5cm. (T3) 2. High risk of residual tumor or surgical margin positivity on resection 3. Large tumor in a small breast 4. Poor histological differentiation 5. Extensive intraductal component (>25% of tumor is DCIS) Advantages : Breast conserving surgery over Mastectomy Improved body image and higher treatment satisfaction No greater fear of recurrence compared with Mastectomy Lower rates of major depression, anxiety and Insomnia
T1 breast tumor
Multicentric tumor
Extensive in situ cancer
T4b breast tumor