A commentary on the role of the surgeon in primary breast cancer

Abstract

The function of the surgeon remains the same relative to the management of primary breast cancer. What has changed is our perception of the biology of the disease and our understanding of data evaluation and analysis. This presentation provides an overview of some of the more important findings which have altered our understanding of breast cancer and which have led to a reassessment of the basis for cancer surgery. It also emphasizes why controlled clinical trials are necessary for obtaining credible data. To most succinctly summarize the author's position regarding a number of critical controversies related to primary breast cancer surgery, answers are presented to ten of the questions most frequently posed by surgeons regarding surgical therapy.

Argyrophilic nucleolar organizer region (AgNOR) area per nucleus as a prognostic factor in breast cancer

“…As the new concept proposed by Fisher [43] is becoming more accepted, the less often invasive surgery is being performed, even in Japan [MI. Fisher [43] emphasized that breast cancer is a systemic disease.…”

“…As the new concept proposed by Fisher [43] is becoming more accepted, the less often invasive surgery is being performed, even in Japan [MI. Fisher [43] emphasized that breast cancer is a systemic disease. We have also been considering some factors independent of regional lymph node status, since the death or relapse of some node-negative patients has been experienced in our hospital.…”

“…Fisher [43] emphasized that breast cancer is a systemic disease. We have also been considering some factors independent of regional lymph node status, since the death or relapse of some node-negative patients has been experienced in our hospital.…”

Flow cytometric analysis for assessing the malignant potential of breast cancer

“…In recent years, different surgical procedures for early breast cancer, varying from lumpectomy to radical mastectomy, have been performed in many countries. In the randomized trials of NSABP [20], patients with stage I breast cancer were treated by radical mastectomy, total mastectomy, and total mastectomy plus regional irradiation. Both survival and distant metastasis in total mastectomy were not statistically different from those in the radical mastectomy group.…”