[Current surgical treatment of breast cancer in Japan and its rationale: foreword]

This is a foreword to a collection of articles specially dedicated to describing the present status of local treatment of breast cancer patients in Japan, which continues to be a source of controversy in the midst of collaborative efforts between surgeons, pathologists, and medical and radiation oncologists. Surgical treatment of breast cancer consisting of procedures on the breast parenchyma and on lymph nodes do not appear to have reached the expected technical perfection. A variety of surgical procedures are performed under the name of breast-conserving surgery with widely varied rates of application ranging from 20-85% depending upon the institution. With regard to sentinel node biopsy/dissection, diversified techniques such as different types of tracers and injection sites are currently being utilized, and furthermore long-term analysis may be necessary to determine the superiority as compared with other approaches such as lower axillary sampling/dissection and 4-node biopsy. Since all efforts should be made to prevent locoregional tumor recurrence, surgeons must be alert and attuned to all the details of surgery. Continued efforts of surgeons with a broadened perspective will lead to the improvement of local treatment of breast cancer with the ultimate goal of obtaining better local control and consequently better long-term survival outcomes.