ASO Author Reflections: Why the Surgeon, Who is the Person Most Influential in the Management of Breast Cancer, Must Have a Multidisciplinary Mindset

Excerpt

It has been puzzling to witness that since the landmark studies of Fisher & Veronesi, the recommendations by these investigators and the ensuing NCI/NIH directives endorsing breast conservation (BCS) as an equivalent option for the care of the breast cancer patient have been upended.1 Many have demonstrated the increase in mastectomy rates in the past 15 years, despite the corollary observation by radiologists that the average size of breast cancer is under 2 cm, in great part due to the increasing sensitivity of screening mammography.2 How could this be? For example, local recurrence of a node negative luminal A tumor type is 0.8% at 5 years, a figure nearly impossible to supersede with mastectomy with all of its attendant complications and reconstructive undertakings. …