The role of local treatment for primary carcinoma of the breast.

The rationale of the conventional treatment of carcinoma of the breast by radical mastectomy is examined and is shown, in the light of modern concepts of the biology of the disease, to be faulty. It is proposed that the primary management of breast cancer should have three aims--preoperative diagnosis so that mastectomy may be avoided in patients with overtly disseminated disease, adequate local control of the disease with the maintenance of good life quality, and staging by minimal examination of the axillary contents or pectoral node biopsy as a guide to such adjuvant systemic therapy as may prove necessary.