Progress in the treatment of early breast cancer

Progress has been made in the prevention and early detection of breast cancer. As a consequence, there have been changes in treatment. Mammography, the standard screening procedure, is more widely accepted so that in situ and minimal lesions are diagnosed more often. There is a trend toward evaluation of local excision or observation as the treatment for noninvasive lesions. For invasive lesions, differences of opinion persist regarding the use of lumpectomy and irradiation versus modified radical mastectomy, but increasing data are helping to put the decisions on a sounder basis. Postoperative adjuvant therapy for patients with node negative lesions is still being evaluated. Up to the present time, these changes have not had an impact on mortality, but insufficient time has passed to evaluate the results of treatment of these very early lesions.