[Surgical procedure and adjuvant therapy in breast cancer]

Modified radical mastectomy (Auchincloss or Patey) have been generally performed for early breast cancer. And this method has shown better prognosis compared with standard (Halsted) or extended radical mastectomy. Also minor conservative surgery (breast or nipple preserving procedure) with or without radiation has been recently tried in small groups of Japan. Postoperative adjuvant chemotherapy (FEMP) has been used in patients proved histologically vascular invasion of cancer cells in our department. Postoperative radiotherapy were undertaken in patients with 4 or more positive axillary nodes or positive parasternal and supraclavicular nodes. Extended radical mastectomy is considered as a favorable method to improve the disease-free survival of the patients with advanced breast cancer, including the combination of chemotherapy, endocrine therapy and radiotherapy. It is important that surgical procedures for breast cancer should be selected and conducted along with a multimodal treatment according to stage for a case by case under the concept of "systemic disease".