Breast-conserving surgery and radiotherapy in early-stage breast cancer: the importance of local control

Breast-conserving therapy is a successful, well-studied, and scientifically validated treatment of early-stage breast carcinoma. This approach has enormously improved the quality of life and cosmetic outcome for appropriately selected and treated patients while achieving the same long-term survival rates as mastectomy. This article reviews the evidence showing the importance of achieving initial local control to maximize breast cancer-specific survival rates, the impact of systemic therapy on the local control rates achieved with breast-conserving therapy, the integration of chemotherapy with radiation therapy, and the role of breast magnetic resonance imaging in breast-conserving therapy.