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Breast Conservation Therapy

In 1973, the National Surgical Adjunctive Breast Project instituted a clinical trial, the B0-6, that compared mastectomy (the surgical removal of the breast, nipple, and axillary lymph nodes) to lumpectomy with whole breast irradiation for Stage I and II breast cancers. After 25 years of follow up, it was shown that there was no difference in overall or disease free survival in this subset of patients.

Furthermore, data from the NSABP B-18 and B-27 trials showed that we could even convert women who had large tumors and would need a mastectomy, to breast preservation by giving upfront or preoperative or neoadjuvant chemotherapy. In 1992, the NIH released a consensus statement saying that breast preservation was preferable to mastectomy as it allowed a woman to keep her breast and it offered equivalent survival.

Because women are now being diagnosed at an earlier stage, nearly 70% of them are able to have breast conservation therapy. All women with invasive breast cancer need some type of axillary staging and this is usually done through the sentinel lymph node biopsy.

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