Symposium on the management of early breast cancer (stages I and II). Part II: Clinical experience with treatment methods. 3. Conventional surgery and radiotherapy.

Conservative surgery (local tumour excision) for early breast cancer gives long-term survival rates comparable to those after radical treatment. Irradiation postoperatively reduces recurrence in the breast by at least 50%. The value of irradiating the internal mammary nodes in patients whose lymphoscintogram confirms the presence of cancer in these nodes remains to be determined. Radical surgery does not improve the survival rate and excessively radical radiotherapy may induce morbidity equal to the operation it is intended to replace. The demise of radical surgery is predicted and a plea made for the use of adjuvant chemotherapy or hormonal therapy, or both, for high-risk patients following conservative treatment.