Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery

A 45-year-old woman is found to have invasive breast cancer and undergoes lumpectomy with dissection of the sentinel lymph nodes. After 6 months of adjuvant chemotherapy, radiation therapy is recommended. Radiation therapy has been shown to reduce the risk of local recurrence after breast-conserving surgery. The most serious complications include lung and heart injury and secondary cancers. Radiation therapy has been shown to reduce the risk of local recurrence after breast-conserving surgery. The most serious complications include lung and heart injury and secondary cancers. Foreword This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the author's clinical recommendations. Stage A 45-year-old woman with a family history of postmenopausal breast cancer (in a maternal aunt) discovers a mass in the upper outer quadrant of her left breast. A mammogram reveals a spiculated density considered suspicious for cancer, and a core biopsy of the lesion reveals a high-grade infiltrating ductal carcinoma that is negative for estrogen and progesterone receptors and for HER2/neu. A lumpectomy and dissection of the sentinel lymph nodes are performed. Pathological evaluation reveals a 1.5-cm infiltrating ductal carcinoma with 3-mm disease-free surgical margins and two negative sentinel lymph nodes. After undergoing 6 months of adjuvant chemotherapy, the . . .