In the past 15 years, surgery for breast cancer has been scaled back even further for early stage disease. Now excision of the primary lesion with a margin of normal tissue, lumpectomy or breast conservation surgery, has become the procedure of choice. For in-situ carcinoma, addition of local radiation has been shown to reduce the risk of local recurrence.
An alternative to lumpectomy and radiation for in-situ carcinoma is total mastectomy, removing all the breast tissue. This eliminates the need for local radiation.
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If the primary lesion is invasive rather than in-situ (see breast cancer background segment), an axillary sampling is performed and adjuvant radiotherapy is also used to reduce the incidence of local recurrence. Most recently, trials focused on identifying and sampling only one or two sentinel lymph nodes show promise of staging the axillary node status without the potential complications of more extensive axillary dissection.
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