Indications and contraindications for breast preservation in patients withbreast cancer

Roughly 70% of all patients with breast cancer can be treated. by breast-pr eserving procedures under optimal circumstances. Risk factors for the devel opment of local recurrences are age, angioinvasion, poor differentiation of the tumor, negative steroid hormone receptors, extensive intraductal compo nent and positive margins. Contraindications for breast preservation are la rge tumors without remission after preoperative chemotherapy, multicentrici ty, extensive intraductal component, large ductal carcinoma in situ, inflam matory breast cancer after preoperative chemotherapy, Paget disease and loc al recurrence after breast-conserving surgery. Preoperative needle biopsy a llows determination of nearly all of the risk factors. To further increase the rate of breast conservation, preoperative chemotherapy should be used m ore extensively.