Current practice favours mastectomy for these women. Other women who may require mastectomy include patients with a recurrence or new primary tumour in a previously diseased breast, ingrown tumours, inflammatory breast cancer, or cancerous lesions throughout the breast. Such women are a minority, though. Among the remainder of women, breast-conserving surgery is gaining ground with each passing year, says Olivotto. Such women should not be denied that choice.
Chemotherapy agents can be very toxic and can kill tumour cells and regular cells alike.
Tamoxifen, on the other hand, works by blocking cell receptors for the female hormone estrogen. Unlike chemotherapy, tamoxifen targets tumour cells specifically and doesn't wreak havoc on other cellular processes. But tamoxifen carries its own risks, most notably the risk of endometrial cancer, which increases about four-fold after five years of use. Still, the clinical pendulum is swinging toward more widespread use of both tamoxifen and standard chemotherapy. This includes women who have had all detectable cancer removed in surgery.