Current status of conservative surgery and radiotherapy as primary local treatment for early carcinoma of the breast.

Since it is now recognized that breast cancer is commonly a systemic disease at presentation, it is clear that local treatment is limited to providing local tumor control, and that effective systemic therapy is required for the eradication of micrometastatic disease. We here review the current status of conservative surgery and radiotherapy in the treatment of early breast cancer. Results from retrospective studies support the view that this combination is highly effective in achieving local control and maintaining good cosmetic results. Results at five and ten years from prospective trials indicate that survival using this approach is comparable to that of mastectomy. Though further follow-up is required, we do not believe that a large survival difference in favor of either approach will emerge.