A rationale for surgical detection of cancer without hospitalization

During 1980, in strict accordance with indication schedules outlined for breast, skin, oral cavity, lymph node, and soft tissue lesions, 2,499 patients were selected and operated on in the outpatient department of our institution. The main purpose was early detection of unexpected cancer without hospitalization. Of 1,266 breast operations, 99 (7.8%) unexpected carcinomas and 67 (5.3%) borderline or precancerous lesions were detected, with a higher rate of T1 and N- cases than were found in hospitalized breast carcinoma patients: T1, 61% vs 38%; N-, 68% vs 54%. The specimens of 1,048 skin and oral cavity lesions revealed 261 (24.9%) squamous or basal cell carcinomas, and most of them were cured by the outpatient surgery itself. Removal of 149 suspicious nevi revealed 20 (13.4%) unexpected malignant melanomas; 185 operations on lymph node and soft tissues detected 44 lymphomas (31 unexpected), 36 metastatic lymph nodes (five unexpected), and six sarcomas (five unexpected). These data confirm the validity of and necessity for surgical outpatient operations in selected cases.