早期乳腺癌的治疗是复杂的，需要进行多学科护理，并为每个患者提供多种治疗选择。随着共同决策的重要性日益提高，患者与医生之间的对话变得越来越复杂。这些对话需要对不同治疗方法的风险和益处进行真实的披露，以适应每个患者并易于理解。对于大多数患者来说，应该将乳腺保留治疗与放射疗法结合作为黄金标准的局部治疗方式，因为其长期和改善的生活质量结果类似。减弱疗法目前在局部区域治疗研究中处于前沿地位，还需要进一步研究来确定适合减少哨兵淋巴结采样、完全省略哨兵淋巴结活检和省略放射疗法的最佳患者群体。对于未来的试验，需要建立更好的终点考虑患者中心的结果以及复发情况。 版权©2023作者。由Elsevier Ltd.出版。保留所有权利。

Treatment for early-stage breast cancer is complex, requiring multidisciplinary care with a multitude of treatment options available for each patient. Coupled with the rising importance of shared decision-making, patient-physician conversations are progressively more complicated. These conversations require frank disclosure of risks and benefits of the different treatment modalities in a way that is individualized for each patient and simple to understand. In most patients, breast conserving therapy with radiation should be presented as the gold-standard local treatment given similar long-term and improved quality of life outcomes. De-escalation is currently at the forefront of research in loco-regional treatments, and further investigations are required to best determine the optimal patient populations for reduced sentinel lymph node sampling, omission of sentinel lymph node biopsy altogether and omission of radiation treatment. For future trials, better endpoints need to be established considering patient-centered outcomes as well as recurrence.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.