Breast conservation surgery for breast cancer is indicated in which one of the following conditions?: (A) T1 breast tumor, (B) Multicentric tumor, (C) Extensive in situ cancer, (D) T4b breast tumor
Answer is A. 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