Controversies in the handling of Cancer of breast

The handling of the breast Cancer is based on three fundamental pillars that are: the surgery, the radiotherapy and the chemotherapy, at the moment the controversy rests in that moment in that it should be given the radiotherapy and the shortcomings of the same one in the treatment. It is important then to clarify which is the ideal moment to begin the radiotherapy, for what the patients can be divided in two groups: 1 - Those to those who are made conservative surgery and later radiotherapy in the breast. 2 - those to who that are practiced radical mastectomy and later radiotherapy. In the conservative surgery there is more impact in the delay and local control of the tumor while in the other ones (second group) there is not a significant impact. The best study is that of the U. of Harvard that includes but of 200 patients to those that were given initial chemotherapy and another group with initial radiotherapy that then received chemotherapy. When the radiotherapy took a long time for 16 weeks or more, there was more fail in the breast, being but high the recurrence incidence. If the patient had intraductal tumor or with positive margins, they were more frequent the fault. In the patients with radiotherapy and later chemotherapy, had but metastasis incidence, for what it concludes that if there are as much positive margin as tumor extensive, first the radiotherapy it should be administered and later the chemotherapy