Abstract
Between January 1982 and April 1989, 129 patients with 133 carcinomas were treated by conservative surgery and irradiation. Surgery involved thorough excision of the tumor with pathologically clear margins and level I and II axillary dissection. Selection criteria for breast conservation were derived from those of the National Surgical Adjuvant Breast Project (NSABP) B-06 protocol and from the guidelines of the 1985 International Workshop conducted at the Memorial-Sloan Kettering Cancer Center in New York City. At 32 month's mean follow-up, three recurrences (2%) required mastectomy; five distant metastases yielded a 96% disease-free survival rate; and one death gave a 99.2% overall survival rate. Although follow-up in this personal series is too short to draw any firm conclusions, these results do mirror the initial results from the NSABP randomized study comparing conservative surgery with mastectomy. Successful conservative breast cancer treatment requires meticulous surgery in tumor excision and axillary dissection. Thorough, precise pathological examination of histologic characteristics and tumor margins is essential, as is a multidisciplinary approach involving the diagnostic radiologist, surgeon, pathologist, radiation oncologist, and medical oncologist.
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