Conservative.

A pooled analysis of two Korean retrospective studies reports that women with T1-2N1 triple-negative breast cancer (TNBC) achieve a higher overall survival rate at 5-years when undergoing breast conservation followed by adjuvant taxane-based chemotherapy and whole breast (with or without nodal) radiation than their counterparts who undergo mastectomy followed by adjuvant taxane-based chemo without radiation. Even when controlling for demographic and pathologic factors, those rates continued to significantly differ at 95% versus 88%, respectively. These provocative results aren’t novel, but any conservative appraisal of a retrospective survival benefit with breast conservation has to recognize the potential for some pretty liberal uncaptured selection bias.