A commentary on the role of the surgeon in primary breast cancer.

The function of the surgeon remains the same relative to the management of primary breast cancer. What has changed is our perception of the biology of the disease and our understanding of data evaluation and analysis. This presentation provides an overview of some of the more important findings which have altered our understanding of breast cancer and which have led to a reassessment of the basis for cancer surgery. It also emphasizes why controlled clinical trials are necessary for obtaining credible data. To most succinctly summarize the author's position regarding a number of critical controversies related to primary breast cancer surgery, answers are presented to ten of the questions most frequently posed by surgeons regarding surgical therapy.