Baum M
Ann R Coll Surg Engl. 1983 Sep;65(5):289-92.
The most important advance in the management of early breast cancer over the last 20 years, has been the conceptual revolution whereby the mechanistic/anatomical view of the disease has been replaced by a more complex biological model. As a result of this paradigm shift, the role of local therapy has been redefined and a steady momentum towards a more conservative approach has been initiated. Furthermore, the trials of adjuvant systemic therapy, although not producing the anticipated major breakthrough, have at least demonstrated that the natural history of the disease can be influenced in a favourable direction. Future progress depends on a continuing involvement of all surgeons in multicentre trials and resistance to the establishment of a new therapeutic dogma.
过去20年里，早期乳腺癌治疗最重要的进展是观念上的革命，即疾病的机械/解剖学观点已被更复杂的生物学模型所取代。这种范式转变的结果是，局部治疗的作用得到了重新定义，并开启了朝着更保守方法发展的稳定势头。此外，辅助性全身治疗试验虽然没有取得预期的重大突破，但至少证明了疾病的自然病程可以朝着有利的方向受到影响。未来的进展取决于所有外科医生持续参与多中心试验，并抵制新治疗教条的形成。
