Multidisciplinary approach to breast cancer control.

A multidisciplinary approach to breast cancer control was developed through a network of 22 hospitals, and data were collected over two time periods to evaluate the impact of the network. A total of 1,800 cases of female breast cancer treated during the baseline period of 1971 to 1973 were compared with 2,102 current cases treated during the 1975 to 1977 study period. These cases were compared with regard to detection, diagnosis, and primary therapy. Several improvements in the diagnosis and treatment of patients studied in the later period indicate the program has had a positive impact. Improvements include an increase in case accrual by an average of 100 cases per year; an increase in detection of early (in situ and localized) and advanced disease; an increase in the proportion of patients whose interval from first symptoms to diagnosis was less than one month; a threefold increase in the proportion of patients diagnosed before admission; the increased use of simple or modified radical mastectomy (from 11% to 25%); a reduction in the number of patients whose mastectomy was done by a physician who did five or fewer mastectomies per year; an increase in the number of patients receiving bone, liver, or spleen scans; and an improvement in the quantity and quality of information in hospital charts, such as family history of cancer, history of benign breast disease, and menstrual history. Data are also provided on primary therapy and method of detection according to stage and tumor size.