[Surgery limited to the breast for breast carcinoma]

A series of controlled trials was started at the Milan Cancer Institute 16 years ago. The first trial started in 1973 and compared the Halsted mastectomy with an extensive surgical resection (quadrantectomy), associated with axillary dissection and radiotherapy (QUART). No differences in survival were observed between the two treatments. A second study, conducted between 1984 and 1987, compared the QUART technique with the tumorectomy, axillary dissection and intensive radiotherapy. Results will be shortly available. A third study is now in progress comparing the QUART techniques with a pure surgical technique, consisting of quadrantectomy and axillary dissection without radiotherapy. The patients accrual will be terminated by the end of 1989. Several questions are still open to be answered.