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Medicine Oncology cb429edb

A 53-year-old woman presents to the clinic for evaluation of a new left breast lump that she discovered 1 week ago. The nodule is not painful; she feels well and has no other symptoms. On physical examination the lump is palpable, and there are no axillary lymph nodes. The mammogram confirms the presence of a 1-cm breast mass which on biopsy is positive for invasive breast cancer. Which of the following is the most appropriate local therapy for her tumor?

A
simple mastectomy with axillary dissection
B
radiation therapy to breast and axilla
C
local excision plus radiation therapy
D
local excision and axillary dissection followed by radiation therapy
High-Yield Explanation
Breast-conserving surgery is now recommended for small tumors. Radiation therapy will decrease local recurrence rates. For tumors < 1 cm, adjuvant therapy is indicated only if axillary nodes are positive. Therefore, in this case, an axillary dissection will provide important therapeutic information. However, this is an area of rapidly changing knowledge and practice.

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