Changing indications for breast conserving therapy: proportion of patients with operable breast cancer suitable for breast conservation.

The changes in indication for breast conserving therapy and the proportion of operable stage-I and stage-II breast cancers suitable for breast conserving therapy were studied in three time periods. The percentage of patients treated with breast conserving therapy gradually increased through the years: 77/199 (39%) in 1980-1981, 122/245 (50%) in 1985-1987, and 168/305 (55%) in 1987-1989. Using the actual selection criteria more patients might have been candidates for breast conserving therapy: 69, 64 and 59 per cent respectively. In the period 1987-1989 almost all patients who were considered good candidates for breast conserving therapy had a breast sparing procedure. Indications widened in relation to age limit (less than or equal to 70 years) and, over the years, more factors became relative contra-indications: very young age, presence of extensive intra-ductal component, data from mammography (multicentricity, size and aspect of the lesion). About 40 per cent of the patients were no appropriate candidates for breast conserving therapy. This percentage would be higher when operable stage-III patients would have been included.