Abstract
The annual change of operation methods on 504 primary breast cancers in Takasaki National Hospital was showed for the 13-year period from 1984 to 1996. The radical mastectomy (Halsted) was replaced by the modified radical mastectomy in 1991. A breast conserving surgery (BCS) has been performed since 1992 and increased to be 25% of all cases in 1996. A subcutaneous mastectomy has been done since 1993 and there were 14 cases. In these surgeries all patients have no recurrence. An immediate breast reconstruction has been practiced to be 55 patients (32% in all) since 1994. The procedure was 47 of latissimus dorsi musculocutaneous flap (LDMC), 6 latissimus dorsi muscular flap and one rectus abdominis myocutaneous flap. The LDMC method was technically easy and safe without major complications. According to the postoperative questionnaire of QOL, immediate breast reconstruction showed to improve significantly the patients' QOL concerning a body image more than modified radical mastectomy. The choice of surgical procedure shoud be decided by each patient under the practice of informed consent in consideration of clinical stage, prognosis in disease and a better QOL.
