Prechtel K, Gross C
Langenbecks Arch Chir. 1978 Apr 7;344(4):281-91. doi: 10.1007/BF01261266.
This study is an attempt to evaluate the necessity of radical surgery based on the incidence of tumor remnants and lymphnode metastases in amputated breast after diagnostic excision. The material included 600 female patients, from 27-86 years old (mean age 58 years) examined at the Institute of Pathology University of Munich between 1969 and 1974. Retrospectively 36% of the specimen would have been free of tumor after en bloc resection, 21% simple mastectomy and 19% after simple mastectomy with additional axillary lymph-node disection. In fact, however, radical mastectomy was necessary in 25% for total removal of the tumor. As no methods for exact preoperative determination of tumor extension are yet known and as there is a high risk of recurrant tumor because of insufficient excision, organ-preserving surgical procedures still will be restricted to a few individual and selected cases of breast carcinoma presuming the patients consent.