Surgical considerations in selecting local therapy.

Clinical trials have demonstrated that patients treated with lumpectomy and radiation therapy have long-term survival rates equivalent to those treated with classical forms of mastectomy. Perhaps questions remain about appropriate treatment of the very smallest and the largest of operable breast tumors, but the majority of patients with primary breast cancer can be successfully treated with conservative surgery and radiation. Factors involved in surgical decision making, technical features of lumpectomy, and postoperative treatment are discussed.