[Treatment of early T1 small T2N breast cancers. Our experience at the Yaounde General Hospital. 21 cases]

From February 1989 through February 1993, a group of 23 patients suffering from T1 mammary carcinoma small T2 N-MO was treated in the radiotherapy department of the Yaoundé General Hospital, according to a simplified procedure. A first conservative surgery of tumorectomy type (3 cases) and quandrantectomy type (4 cases) was carried out, followed by a postoperative irradiation. In 14 cases, a Patey type radical surgery preceded a local/regional radiotherapy. The general treatment was made up of only a hormonotherapy without chemotherapy. After a 4-year decline, there were 5 cases--i.e. 23.8%--of ganglionic and/or metastatic relapse. In the light of research data, we are analysing the reasons for these unexpected therapeutic failures in this group of tumor considered as favorable prognosis. We raised the problem of the inability of the prognosis factors, presently defined by means of histological and biological factors, to detect all the especially aggressive cancers. We carried out a general review of the new factors defined essentially from molecular and genic bases. We offered an approximative solution which makes it possible to by-pass the technological difficulties in having access to the new factors.