[The spread of breast cancer and indications of breast preserving operation]

Pathological investigations for intramammary spread of breast cancer of 205 partially resected specimens were performed by making continuous section every 5 mm width of the whole specimen. The materials were 167 quadrantectomized and 38 lumpectomized specimens. The results showed that the margin of 15.6% of quadrantectomized and 28.9% of lumpectomized specimens were positive for cancer, main causes of which were intraductal spread of cancer occupying 65% of positive margin in quadrantectomy and 91% in lumpectomy, multiple cancer, interstitial spread of cancer and so on. Multiple cancers were found in eleven (6.6%) quadrantectomized and in one (2.6%) lumpectomized specimens. Second cancers were 11 noninvasive ductal and 3 invasive cancers, including two triple cancers. Fifteen cases of quadrantectomy and 4 of lumpectomy were changed to be mastectomized because of positive margin or nodal involvements. Radiotherapy was performed for 33 cases. The median 31 months follow-up results of 186 partially mastectomized breast in 184 patients were as follows; one local recurrence in lumpectomy, two new cancers in residual breast, two distant metastases and one death for other cause of death. Quadrantectomy plus axillary dissection without radiotherapy assured of pathological complete resection was safe enough at the present.