Towards appropriate local surgery for patients with breast cancer

Abstract

Guidelines for management of a disorder are usually published because opinion-makers feel that sufficient evidence has accrued to direct their fellow professionals into a specific course of action. By implication, they must think that not enough patients are treated “correctly”. In June, 1990, the National Institutes of Health (NIH) consensusdevelopment conference on the treatment of a early-stage breast cancer endorsed the concept that wide local excision (conservation) was as effective as mastectomy stage I or II breast cancer. 1 Early Stage Breast Cancer. Consensus Statement. NIH Consensus Development Conference. June 18–21, 1990. Vol 8 No 6. Bethesda, Maryland: National Institutes of Health, 1990. Google Scholar Either operation should be accompanied by level II axillary surgery and that conservation surgery should always be followed by radiotherapy. Relation between appropriateness of primary therapy for earlystage breast carcinoma and increased use of breast-conserving surgeryAlthough most women undergo appropriate care, the appropriateness of care for early-stage breast cancer in the USA declined from 1990 to 1995. Because the proportion of all women who were treated by breastconserving surgery increased, and because this approach was more likely than was mastectomy to be applied inappropriately, the proportion of all women having inappropriate care increased. Full-Text PDF