Which of the following is a contraindication to lumpectomy and radiation?

• A. Lesion visible on mammograms
• B. Very small breast
• C. Positive margins
• D. Healthy collagen tissue

Answer: (C)

In the context of breast cancer treatment, a contraindication to lumpectomy and radiation refers to a condition that would prevent a patient from being eligible for these specific treatments. Positive margins indicate that cancerous cells are present at the edges of the removed tissue, suggesting that not all cancer has been excised. This presents a significant concern because it increases the likelihood of cancer recurrence in the breast.

If positive margins are found, additional surgical procedures, such as a re-excision, may be necessary to remove more tissue and ensure that the cancer has been fully addressed. Therefore, proceeding with a lumpectomy and radiation in the presence of positive margins could lead to inadequate treatment of the cancer. Consequently, this situation would be classified as a contraindication for those procedures, as the priority is to ensure complete removal of cancerous tissue before considering lumpectomy and radiation as part of a treatment plan.

In contrast, factors like a lesion visible on mammograms, having a very small breast, or healthy collagen tissue do not contraindicate lumpectomy and radiation. These factors might influence treatment planning, but they do not prevent the procedures from being performed.