[Surgical treatment of breast carcinoma - 30 years' experience]

Although, carcinoma of the breast, because of its high frequency and many specific properties, belongs to the most studied of malignancies, it remains a fact that during the past 3 decades the incidence of mortality from this disease has changed little. The authors, drawing on their 30 years experience, demonstrate that the mortality rate and the survival rate depend on the kind of surgical intervention as well as the stage of development of the disease at the moment of operation. For this purpose a total of 655 operated cases were recorded (643 female and 12 male) using the Steinthal classification. In this series 68.1% were infertile; the upper outer quadrant was affected in 54% of cases; histologically the most frequent form was scirrhous adenocarcinoma. The greatest number of patients belonged to stage II and III, whereas the average time from the appearance of the first symptoms up to the medical examination was 6-12 months. Further spread of the disease and regional metastases were presented in more than 65% of cases. It was demonstrated that surgical procedure used depended on the extensiveness of the disease; modified radical mastectomy was performed in 54.2% of patients and Halsted's radical mastectomy in 40.15%. 185 patients were given the control examination. A strictly statistical analysis of the results confirmed that whereas the length of survival was not significantly affected by the kind of operation, the mortality rate did vary according to which surgical procedure was used. The author conclude that there is no best or unique surgical method and that each patient should be examined in a multidisciplinary way, and his treatment should be carefully planned.