Breast conservation therapy--surgical aspects

Breast conservation therapy is now accepted as an alternative to mastectomy for early stage breast cancer. In 1991 the NIH recommended a regime consisting of the excision of a primary tumour with a 1 cm-margin of breast tissue around and an axillary node dissection followed by postoperative administration of 45-50 Gy irradiation. Although this regime is popular in most centres, several issues remain controversial. These are (1) selection of cases, (2) surgical technique, (3) histopathology and radiology, and (4) adjutant therapy. In this presentation I shall deal mainly with the surgical aspects of breast conservation.