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Nonmastectomy treatment of breast cancer. Current status of excision plus radiation.

Treatment of primary breast cancer with excision of the tumor plus radiation is now an accepted alternative to mastectomy in women who desire breast preservation and have a suitable clinical presentation. Tumor size and location should be carefully considered before applying treatment with this method, the primary consideration being whether the breast will be grossly distorted by excision. Women with large breasts are technically more difficult to treat and often have less satisfactory cosmetic results, but large breast size is not a contraindication to nonmastectomy procedures. A patient of any age can be treated with these procedures, but young women who undergo radiation treatment will have a longer period at risk for any late complications of irradiation. Compulsive attention to surgical and radiotherapeutic detail produces the best results. Careful and close long-term follow-up of these patients is essential because local recurrence is treatable with mastectomy.