Patient selection criteria for conservation surgery versus mastectomy: Memorial Hospital breast service experience.

Breast cancer remains the most common noncutaneous malignancy of women. Although the incidence of the disease continues to rise, most women now present with early (stage I or II) disease. Breast conservation has been demonstrated to be equal in efficacy to mastectomy in such patients in six modern-day randomized trials. The utilization of breast conservation has been slow throughout the United States. At Memorial Hospital the utilization of breast conservation almost equals that of modified mastectomy in the treatment of 950+ annual primary operable cancers. Excellent local-regional control can be obtained with a defined surgical approach to the primary tumor and axillary nodes, radiotherapy to the breast with a boost to the primary site, and finally patient selection.