To evaluate the effectiveness of local and regional tumor control, one has to consider the following end points: locan and regional tumor control and survival. Halsted and his generation assumed that survival depends upon eradication of local regional tumor. Local recurrences were considered to be the result of inadequate application or surgical skill. In the past decades the trend is for less radical breast cancer surgery. The controversial results of many comparative studies showed remarkable similarity of survival rates following various forms of therapy. Therefore, survival rates are no longer an indicator for the breast operative procedure. Treatment, therefore, should be highly individualized. Nonetheless there is an improvement of survival today because of early diagnosis and smaller carcinomas that can be cured more readily. In the past women delayed treatment because of the fear of mutilation from radical mastectomy. Today they come earlier to the physician, knowing that they have a chance to avoid mastectomy or have breast reconstruction. Thus enters the plastic surgeon. With the widely available possibility of reconstruction of the breast, the plastic surgeon offers both the patient and the surgeon a reprieve. To the women he offers a first-rate solution for her fear of loss of femininity. To the surgeon he offers the time needed to explore and evaluate calmly alternative methods of treatment without undue pressure to compromise his scientific convictions.
|Number of pages||6|
|Journal||Clinics in Plastic Surgery|
|State||Published - 1984|