J.Jpn. Surg. Soc.. 79(8): 730-734, 1978

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Report on the annual meeting

SYMPOSIUM CONTROVERSY IN SURGERY BREAST CANCER

At present, great controversy exists relative to the proper primary treatment for breast cancer. Ten year survival rates of patients treated surgically for breast cancer at Cancer Institute Hospital between 1946 and 1966 were evaluated. Ten year survival rates were 67.7 per cent for the 1177 patients treated by radical mastectomy, 32.4 per cent for the 173 patients treated by extended radical mastectomy. Ten year survival rate according to the extent of axillary node involvement was essential the same, irrespective of the types of mastectomy performed. Ten year survival rate in 40 patients with proven internal mammary metastases was 30 per cent. However, no significant difference was observed, in the group of medical and central lesions, between radical mastectomy and radical mastectomy plus internal mammary dissection groups, according to the tumor size and axillary status. Prophylactic irradiation of these nodes following radical mastectomy gave us the same results.
Recently, there has been a definite trend toward a pectoral muscle preserving modification of the standard radical mastectomy. From 1974 through 1977, 235 cases of Patey operation and 117 cases of Auchincloss operation were performed. Modified radical mastectomy is suggested for cancer of the breast with no clinically positive axillary nodes and with no apparent involvement of the pectoralis major muscle at surgery. Modified radical mastectomy can remove axillary nodes as completely as radical mastectomy. In our cases, the duration of follow up for the patients is still too short to allow any definitive conclusion.

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