Lumpectomy and irradiation in the treatment of early carcinoma of the breast.

In the past two decades, the increasing ability of radiation to control local tumors in many organs, including the breast, has been well documented. In the past five years, the use of chemotherapy has also assumed a major role in treating micrometastases in breast cancer in selected premenopausal and postmenopausal patients. These two developments have forced a reappraisal of local modalities in the treatment of breast cancer. Even before the advent of chemotherapy it was known that mastectomy alone was not successful in providing local control and thus adjunctive irradiation when axillae were histologically positive has been used to substantially reduce local recurrence rate. Studies now show that excisional biopsy followed by definitive irradiation accomplishes essentially the same local control, stage by stage, as mastectomy with adjunctive radiation therapy in selected cases. Also, similar five- and ten-year survival rates have been obtained in all recent series. Irradiation appears to be at least comparable with mastectomy for control of cancer of the breast, but with better functional and cosmetic results.