New trends in the surgical treatment of primary breast cancer in the Florence District: 1979-1985.

The authors report on a consecutive series of 1979 TIS-T1A-T2A-T3A breast cancer cases surgically treated from 1979 to 1985. The study investigates the impact of recent reports on conservative surgery and of a national treatment protocol for breast cancer, encouraging the use of modified radical mastectomy (MRM) and quadrantectomy, axillary dissection and breast irradiation (QUART) as alternatives to Halsted's radical mastectomy (RM). RM frequency dropped from 52% to 8% in TIS-T1A and from 82% to 20% in T2A-T3A cases in the study period, in favor of MRM and of QUART, which increased from 10% to 54% in TIS-T1A cases. Although surgical choices differ widely according to individual surgeons, a definite trend towards more conservative surgery is evident, which demonstrates how the national treatment protocol has affected current surgical practice.