Kasumi F
Rinsho Hoshasen. 1989 Apr;34(4):419-27.
World changing trend of breast cancer surgery was reviewed historically and reasons why Japan has made slow progress was discussed. Recent worldwide discussions are without exceptions on the limited surgery and radiotherapy for early breast cancer. It is true that the breast conserving method is epochmaking in breast cancer surgery and of great benefit to patient's quality of life. But, success in the breast conserving depends solely on the well balanced radiotherapy between tumoricidal effect and radiation hazards. The author stressed the contradiction of radiotherapy and proposed the surgical quadrantectomy and axillary dissection without radiotherapy till the time comes when radiation effectiveness and hazard will be resolved. It's natural that intensive pathological examination of the resected specimen on serial sections is mandatory.
回顾了乳腺癌手术改变世界的趋势，并探讨了日本进展缓慢的原因。近期全球范围内的讨论无一例外地围绕早期乳腺癌的有限手术和放疗展开。保乳方法在乳腺癌手术中具有划时代意义，对患者生活质量大有裨益，这一点毋庸置疑。但是，保乳手术的成功完全取决于放疗在肿瘤杀伤效果和辐射危害之间的良好平衡。作者强调了放疗的矛盾之处，并提出在放疗的有效性和危害问题得到解决之前，进行手术象限切除和腋窝清扫，而不进行放疗。对切除标本进行系列切片的强化病理检查是必不可少的，这是自然而然的。
