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This article needs attention from an expert on the subject. See the talk page for details. Consider associating this request with a WikiProject. (June 2010) This article's introduction section may not adequately summarize its contents. To comply with Wikipedia's lead section guidelines, please consider expanding the lead to provide an accessible overview of the article's key points. (June 2010) This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (June 2010) Breast-conserving surgery is a less radical cancer surgery than mastectomy. Breast-conserving surgery, as in a lumpectomy removes part of the breast tissue during surgery, as opposed to the entire breast. Contents 1 Absolute and Relative Contra-indications 1.1 Relative contra-indications 2 References 3 External links // Absolute and Relative Contra-indications In the selection of patients for breast conservation treatment with radiation, there are some absolute and relative contra-indications. ===Absolute contra-indications===[1] 1. Pregnancy is an absolute contraindication to the use of breast irradiation. However, in many cases, it may be possible to perform breast-conserving surgery in the third trimester and treat the patient with irradiation after delivery. 2. Women with two or more primary tumors in separate quadrants of the breast or with diffuse malignant-appearing microcalcifications are not considered candidates for breast conservation treatment. 3. A history of prior therapeutic irradiation to the breast region that would require re-treatment to an excessively high total-radiation dose to a significant volume is another absolute contra-indication. 4. Persistent positive margins after reasonable surgical attempts: the importance of a single focally positive microscopic margin needs further study and may not be an absolute contra-indication. Relative contra-indications 1. A history of collagen vascular disease is a relative contraindication to breast conservation treatment because published reports indicate that such patients tolerate irradiation poorly. Most radiation oncologists will not treat patients with scleroderma or active lupus erythematosus, considering it an absolute contraindication. In contrast, rheumatoid arthritis is not a relative or an absolute contra-indication. 2. The presence of multiple gross tumors in the same quadrant and indeterminate calcifications must be carefully assessed for suitability because studies in this area are not definitive. 3. Tumor size is not an absolute contra-indication to breast conservation treatment, although there is little published experience in treating patients with tumor sizes greater than four to five cm. However, a relative contra-indication is the presence of a large tumor in a small breast in which an adequate resection would result in significant cosmetic alteration. In this circumstance, preoperative chemotherapy should be considered. 4. Breast size can be a relative contra-indication. Treatment by irradiation of women with large or pendulous breasts is feasible if reproducibility of patient set-up can be assured and the technical capability exists for greater than or equal to six MV photon beam irradiation to obtain adequate dose homogeneity. References ^ DeVita VT, Lawrence TS, Rosenberg SA: Cancer: Principles & Practice of Oncology, 8th Ed. 2008, pp 1624-1625; Lippincott, Phila. External links American Academy of Family Physicians, Breast-Conserving Surgery, What is breast-conserving surgery? Breast conserving surgery at National Breast and Ovarian Cancer Centre www.nbocc.org v • d • e Operations/surgeries and other procedures of the breast (ICD-9-CM V3 85) Breast surgery Breast-conserving surgery (Lumpectomy) · Mammoplasty · Mastectomy (Radical mastectomy) · Breast implant · Mastopexy · Breast reconstruction · Breast reduction Imaging X-ray (Mammography/Xeromammography) · Thermology (Infrared mammography) · MRI (Breast MRI) · Ultrasound (Breast ultrasound) Other Needle aspiration biopsy M: BRE anat/phys noco/cong/tumr proc This surgery article is a stub. You can help Wikipedia by expanding it. v • d • e