THERE is still no general agreement as to the most suitable method of treating operable carcinoma of the breast. We believe that the difficultes in assessing the relative merits of greater and lesser surgical procedures, and the value of radiotherapy in these cases is largely due to the comparison of results in groups of patients which are not strictly comparable.There is great variation in the progress of cases of breast cancer even in patients of the same age, with the same duration of symptoms, and with tumnours of comparable clinical extent. Women with advanced disease and a long history may survive for many years following only limited treatment, whilst some patients who attend hospital early with what appears to be a localised growth, may die of metastases within twelve months of radical surgery and a full course of postoperative radiotherapy.Have we a classification which takes into account the wide range of behaviour in carcinoma of the breast ? The practice of grouping patients according to a system of clinical staging is in general use at the present time, and although of considerable value does not take into full account the nature of the tumour itself. Thus whilst clinical staging provides a guide to the obvious extent of a tumour, it fails completely to indicate the likelihood of occult lymphatic and blood-born metastases being present in what appears to be an early case, nor the speed with which such metastases may develop.

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