Abstract
The purpose of this paper is to investigate indications for minor surgery in patients with breast cancer.
One hundred and twenty-one cases of the infiltrating type of breast cancer were ope-rated on at the Sagamihara National Hospital between 1962 and 1971, and 94 of them were followed up for 10 years following the surgery.
The 10-year-survival rates according to the stage of the disease in these cases were 92% for stage I, 56% for stage II, 36% for stage III and 0% for stage IV. The 10-year-survival rates according to the operative method were 56% for typical radical mastectomy (Br+Ax+Mj+Mn), 66% for paratypical radical mastectomy(Br+Ax+Mj), 73% for Auchin-closs' operation (Br+Ax) and 67% for simple mastectomy. The discrepancies between the 5-year- and 10-year-survival rates were 9%, 13%, 27% and 0%, respectively.
In addition, the 10-year-survival rate according to the stage and the status of involve-ment of the axillary lymph node (Ax. L. N.) was investigated. The results showed 100% for 5 cases of typical radical mastectomy, 88% for 8 cases of pararadical mastectomy and 100% for 7 who had Auchincloss' operation in stage I without Ax. L. N. metastasis; 0% for one who had Auchincloss' operation in stage I with Ax. L. N. metastasis; 73% for 15 cases of typical radical mastectomy, 89% for 9 cases of paratypical radical mastectomy and 100% for one who had Auchincloss' operation in stage II without Ax. L. N, metastasis; 41% for 17 cases of typical radical mastectomy, 30% for 10 cases of paratypical radical mastectomy and 0% for one who had Auchincloss' operation in stage II with Ax. L. N, metastasis; 100% for one who had typical radical mastectomy in stage III without Ax. L. N. metastasis; 30% for 10 cases of typical radical mastectomy, 100% for one of paratypical radical mastectomy and 0% for one who had Auchincloss' operation in stage III with Ax. L. N. metastasis; and 0% for one who had paratypical radical mastectomy in stage IV with Ax. L. N, metastasis.
We conclude that:
1) The stage at the time of surgery had a better correlation with the survival rate than did the operative method. But the indications for minor surgery should be carefully evaluated because of the great discrepancy in survival rates following such procedures.
2) The indications for minor surgery would be stage I or stage II without Ax. L. N. metastasis.
3) Auchincloss' operation should be indicated for stage I without Ax. L. N. metastasis or no evidence of such involvement.
4) Patey's operation should be done for stage I with Ax. L. N. metastasis or with suspected Ax. L. N. involvement as well as for stage II without Ax. L. N. metastasis because paratypical radical mastectomy is a less invasive procedure than Patey's operation.
