Contraindications to breast conservation

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What are some contraindications to breast conservation?

• Multicentric cancer (i.e., the presence of breast cancer in different quadrants of the breast) is a contraindication. If there is multifocal tumor, however (i.e., more than one focus of cancer localized to the same quadrant of the breast), breast conservation therapy is feasible.

• Size of the cancer relative to the breast size is a relative contraindication. Some clinicians use 5 cm as a cutoff; however, others use a relative measurement as a size cutoff. A 6-cm cancer in a large breast may result in acceptable cosmesis, whereas in a small breast, it would result in unacceptable cosmetic results.

• First-trimester or second-trimester pregnancy.

• History of prior radiation therapy to the chest or mediastinum.

• Active collagen vascular disease.

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