What are some additional issues in breast cancer that require more attention or research?
There are several in the radiation therapy arena: (1) Can accelerated partial breast irradiation (APBI; radiation treatment given directly to the tumor area for a shorter total treatment time) substitute for conventional whole breast irradiation, and, if so, in which patients? At this point, a definitive randomized clinical trial is underway and we will not have the answer for some time. Various groups are working to develop guidelines for its use. We still, however, lack definitive information on the long-term efficacy and safety of this approach. (2) What is the role of breast magnetic resonance imaging (MRI) in a newly diagnosed patient? Breast MRI can detect more cancers than are seen by mammography, but it results in many false positives resulting in extra surgeries, delays, and costs. We don’t have firm clinical data that the routine use of MRI improves important clinical outcomes. (3) What is the best way to integrate breast reconstruction and radiation therapy for patients trea
