[Morphologic criteria in breast-saving surgery]

Efficiency of radiation therapy is dependent on the tumor mass on the one hand and on "radiosensitivity" on the other hand. Thus the locoregional acribic surgery is an urgently required presupposition regarding therapeutic success. In cases of early breast cancer (pT 1 N0 M0) unfavorable prognostic factors may initiate a discussion on adjuvant therapy. From the curative point of view at present breast preserving surgery referring tumors bigger that 2 cm (pT2) should be performed in cases with more advantageous prognostic parameters (low grade malignancy up to grade II a, low degree of tumor cell dissociation, favorable subtype, no relevant lymphangiosis carcinomatosa detectable, etc.). Additional immunohistochemical analysis of the receptor status and the proliferative compartment can be helpful for later therapeutic decisions. The possibility of breast preservation in only palliatively treated cases must be discussed separately.