[Experience and logic of breast conservation therapy]

One hundred patients with an operable breast cancer were treated with intent of breast conservation in six years. Five patients developed contralateral breast cancers synchronously or metachronously. Therefore, a total of 105 breasts were treated. T1 tumors were seen in 55 breasts, T2 tumors in 45, and T3 in 5. Breast conservation were possible for 95 breasts: 52 with T1 tumors,+ 41 with T2, and 2 with T3. No patients have relapsed yet. There is great concern or even fear for breast conservation among surgeons. We discuss about several issues concerning surgical margin, intraductal carcinoma, multicentricity, radiation injuries including carcinogenesis, racial difference of curability, etc., and try to establish the logic of doing or not-doing this treatment which has been proven by randomized clinical controlled trials. Reasons for conservative attitude expressed by the surgeons are irrelevant or illogical. We conclude that it now is the responsibility for the surgeons to prove survival benefit if they would continue to perform mutilating surgery such as Halsted operation.