Breast cancer treatment—current status

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For more than 2,000 years, surgery has been the standard treatment for invasive breast cancer. During the past decade there has been a great deal of controversy regarding the optimal method of primary therapy, and opinions on this subject have changed considerably. Several alternatives to radical mastectomy have surfaced, and while each has its own advantages and disadvantages, the aim is the same—preservation of as much of the breast as possible without jeopardizing the chance for cure.

In this first part of a four-article seminar on breast cancer, Dr Pilch provides a careful and dispassionate history of the surgical approaches—radical, modified radical, and total mastectomy. In part 2 (page 139) he discusses investigational studies of segmental mastectomy—the latest innovation in breast cancer surgery. Part 3 (page 151), by Dr J. Frank Wilson, considers simple excision with irradiation, and part 4 (page 161), by Dr Malcolm S. Mitchell, outlines adjuvant therapies.