The changing pattern of early breast cancer and its primary management at CAMC.

To gauge the impact of screening mammography and the results of clinical trials on the pattern of primary surgical care of early breast cancer, tumor registry data from the Charleston Area Medical Center for 1980-81 was compared to tumor registry data at the hospital for 1990-91. Over the course of 10 years, there was a significant increase in the proportion of patients with T1 tumors (52% vs. 66%, p = .004), a significant increase of cases diagnosed by mammography alone (6% vs. 34%, p < .001), a significant decrease in the proportion of patients with positive axillary nodes (41% vs. 28%, p = .016), and a significant increase in the proportion of patients undergoing breast-sparing procedures (4% vs. 16%, p = .003). However, the percentage of breast-sparing operations at CAMC from 1990-91 was lower than the number reported in the National Cancer Data Base of 1988 (16% vs. 29%). A future study to assess reasons for patient selection of mastectomy or local excision is being planned.