Orientamenti e strategie terapeutiche attuali nel carcinoma mammario. Introduzione

Carcinoma of the breast is a pathology of great social interest for its increase in occurrence and because it is leading cause of tumor-induced death among women in Western Countries. There have been continual changes in the understanding of biological implications of the tumor and in the ensuing therapeutic approaches. Breast cancer is currently viewed as a systemic disorder right from is outset varies widely in behavior within the same histologic type. Hence, the need for a multidisciplinary approach where locoregional treatment (surgery and radiotherapy) is accompanied by systemic (chemotherapy and hormone therapy). As to surgery, there has been a shift away from the radical to the conservative approach which avoids functional and above all psychological mutilation. Beside always being carried out when surgery is not radical, radiotherapy depends on the stage of the tumor. As to chemotherapy, while there is sound evidence proving it to be useful in postoperative adjuvant treatment, its usefulness in preoperative treatment still remains to be demonstrated. Future studies will have to identify new morphobiological parameters of the tumor capable of predicting the clinical behavior and response to therapy of the various types of breast cancer so as to correctly standardize therapeutic actions and their aiming.