Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2009.0107


Impact of genetics and genomics in breast cancer surgery
George Zografos M.D.
Affiliation: From the Breast Unit, (GZ) 1st Department of Propaedeutic Surgery, University of Athens, Greece

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Since there is no abstract available we provide the first paragraph

Beyond advances in guiding targeted therapy, BRCA1 or BRCA2 (BRCA) genetic status is also increasingly influencing decisions on the extent of surgery [1]. Patients with a family history, who test positive for heritable mutations in the BRCA1 or BRCA2 gene, facing a high risk of local failures, may benefit more from aggressive surgery like bilateral mastectomy rather than breast-conserving surgery (BCS) [2].

In light of this progress, the breast surgeon is now facing several challenges. These include selection of the ideal extend of surgery, which includes the options of BCS, ipsilateral mastectomy and bilateral mastectomy. In addition, he or she should have a decisive role in the multidisciplinary decision-making process for patient-tailored adjuvant treatment. This individualized multimodal therapy includes irradiation, whole, partial or no radiotherapy, and systemic empirical chemotherapy and targeted therapy when it is indicated. Often decisions on adjuvant treatment influence the risk of locoregional recurrence and CBC [3]. Because the breast surgeon is primarily responsible for potential local failures, he or she should have a central role in the multimodality treatment decision.


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