Cancer of the breast. A study of prognostic factors as a guide in selecting cases for conservative treatment.

We have analysed 2.649 observations of cancer of the breast in order to study factors influencing the prognosis. We have found a definitive relationship between the extend of the primary tumor, the condition of the regional lymph nodes and the presence or absence of metastases. A careful clinical examination remains of the utmost importance to assess the characteristics of tumor and nodes. This associated with systematic search for bone and pulmonary metastases, are the basic elements of a sound prognosis. The systematic removal of the internal and external mammary node chains in the surgical cases are indispensable to complete the clinical data. So defined the stage of the disease at the time of the first treatment is by far the most important factor in assessing the prognosis. Concerning the treatment, we have obtained better results with surgery associated with radiotherapy than with surgery alone. Therefore in early cases, that is to say cancer confined to the breast, we feel justified to apply conservative surgery associated with radiotherapy.