Contemporary management of breast cancer

Because of mammographic screening, there has been a change in the clinical presentation of breast cancer with an increase in the proportion of women diagnosed with stages 0 and I disease. In addition to the shift in stage presentation, our knowledge of prognostic factors for local and systemic recurrence has increased. This article focuses on the contemporary management of breast cancer in light of these changes. Specifics to be addressed include the selection of patients with ductal carcinoma in situ and minimally invasive breast cancer for breast conservation surgery without radiotherapy, axillary evaluation in small breast cancers, and neoadjuvant therapy in women with locally advanced breast cancer.