Early Breast Cancer

Interactive summary of surgery, radiotherapy, and medical management

This interactive app outlines the management of early breast cancer, including EBCTCG and EORTC evidence, surgical, radiotherapy, and medical management guidelines — organized in collapsible sections below.

🩺 Surgery

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  • Breast-conserving surgery (BCS) + whole-breast irradiation (WBI) is equivalent to mastectomy for survival.
  • Sentinel lymph node biopsy (SLNB) is preferred for axillary staging in suitable patients.
  • Axillary radiotherapy may replace axillary dissection in positive SLN cases (EORTC AMAROS).

🌟 Radiotherapy

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  • Adjuvant RT after BCS reduces recurrence and mortality (EBCTCG).
  • Hypofractionation (40 Gy/15 fractions) and 1-week schedules (FAST-Forward) endorsed for most patients.
  • PMRT indicated for ≥4 nodes or chest wall involvement.
  • APBI for carefully selected low-risk cases.

💊 Medical Management

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  • Endocrine therapy for HR+ disease; ovarian suppression in premenopausal patients as needed.
  • HER2+ disease: adjuvant trastuzumab ± pertuzumab, T-DM1 for residual disease post-neoadjuvant.
  • Adjuvant olaparib for germline BRCA1/2 high-risk disease; CDK4/6 inhibitors in select cases.

📊 EBCTCG & EORTC Evidence

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  • EBCTCG: Adjuvant RT after BCS halves 10-year recurrence, improves 15-year survival.
  • EORTC: Boost vs No-Boost and AMAROS trials inform RT and axillary management decisions.

🧩 Practical Notes

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  • Multidisciplinary team discussion essential for complex cases.
  • Cardiac monitoring required for anthracycline/HER2-targeted therapy.
  • Sequence systemic and radiation therapy per response and agent type.