Surgical treatment of primary breast cancer

The background to the Halstedian era of breast cancer treatment is sketched, and the development of the changes in surgical treatment are outlined, with a review of the most important findings from the several clinical trials conducted to evaluate the alternative operative procedures. Included is a short description of operative techniques; also pathological examination of the operation specimen, and the use of radiation therapy when performing a segmental mastectomy are briefly described. This review is based almost entirely on observations from clinical trials conducted by the National Surgical Adjuvant Breast and Bowel Project.