Relative Contraindications
1. A history of collagen vascular disease is a relative contraindication to breast conservation treatment because published reports indicate that such patients tolerate irradiation poorly. Most radiation oncologists will not treat patients with scleroderma or active lupus erythematosus, considering it an absolute contraindication. In contrast, rheumatoid arthritis is not a relative or an absolute contraindication.
2. The presence of multiple gross tumors in the same quadrant and indeterminate calcifications must be carefully assessed for suitability because studies in this area are not definitive.
3. Tumor size is not an absolute contraindication to breast conservation treatment, although there is little published experience in treating patients with tumor sizes greater than four to five cm. However, a relative contraindication is the presence of a large tumor in a small breast in which an adequate resection would result in significant cosmetic alteration. In this circumstance, preoperative chemotherapy should be considered.
4. Breast size can be a relative contraindication. Treatment by irradiation of women with large or pendulous breasts is feasible if reproducibility of patient set-up can be assured and the technical capability exists for greater than or equal to six MV photon beam irradiation to obtain adequate dose homogeneity.
Read more about this topic: Breast-conserving Surgery, Contraindications
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