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| Level of resources | Local-regional treatment | Systemic treatment (adjuvant) | ||
|---|---|---|---|---|
Surgery |
Radiation therapy |
Chemo-therapy |
Endocrine therapy |
|
Basic |
* |
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Limited |
Breast-conserving whole-breast irradiation as part of breast-conserving therapy Postmastectomy irradiation of chest wall and regional nodes for high-risk cases |
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Enhanced |
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Maximal |
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ABBREVIATIONS: CMF, cyclophosphamide, methotrexate, and 5-fluorouracil; AC, doxorubicin and cyclophosphamide; EC, epirubicin and cyclophosphamide; FAC, 5-fluorouracil, doxorubicin, and cyclophosphamide; and LH-RH, luteinizing hormone–releasing hormone. * Chest wall and regional lymph node irradiation substantially decreases the risk of postmastectomy local recurrence. If available, it should be used as a basic-level resource. ** Breast conserving therapy requires mammography and reporting of margin status *** Requires blood chemistry profile and complete blood count (CBC) testing |
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