50 Years of Breast, Endocrine, and Oncologic Surgery at the Southwestern Surgical Congress: Earlier Diagnosis and Improved Outcomes

Abstract

The proceedings of the Southwestern Surgical Congress (SWSC) over the last 50 years have contained .200 presentations related to the field of breast, endocrine, and oncologic surgery. Of these, I have selected 62 for review. A review of the proceedings revealed that in most areas the papers mirrored the evolution of American surgery over the last half century. The breast presentations, beginning in the early 1960s, challenged the rationale of the Halstedian approach to breast cancer and reported comparable results with less disfiguring procedures. In the field of endocrine surgery, as surgeons began embracing newer techniques in diagnosis (fine needle aspiration [FNA], abdominal computed tomography [CT], and flow cytometry), earlier diagnoses and more information on prognosis became available. The papers related to melanoma presented a persuasive argument away from wider radical resections and amputation to operations with smaller margins, with no discernible effect on survival figures. In the area of abdominal oncologic surgery, the most striking trend seemed to be an increasingly aggressive operative approach to pancreatic cancer at the same time as operative mortality rates fell from .30% to ,5%.