Despite the increased ability to offer breast-conservation techniques to patients with breast cancer, there exist certain groups who may be better served by traditional mastectomy procedures including:
- women who have already had radiation therapy to the affected breast
- women with 2 or more areas of cancer in the same breast that are too far apart to be removed through 1 surgical incision, while keeping the appearance of the breast satisfactory
- women whose initial lumpectomy along with (one or more) re-excisions has not completely removed the cancer
- women with certain serious connective tissue diseases such as scleroderma, which make them especially sensitive to the side effects of radiation therapy
- pregnant women who would require radiation while still pregnant (risking harm to the fetus)
- women with a tumor larger than 5 cm (2 inches) that doesn't shrink very much with neoadjuvant chemotherapy
- women with a cancer that is large relative to her breast size
- Women who have tested positive for a deleterious mutation on the BRCA1 or BRCA2 gene and opt for prophylactic removal of the breasts
- male breast cancer patients.
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