Local control in breast cancer. Old and new lines and analysis of our experience.

The great interest in early breast cancer is caused by hope in the future of treating especially early cancers, extending the indications to a local conservative treatment of the breast with a more and more efficient general treatment. The GIVIO work has proved that the major part of Italian surgeons and gynaecologist don't accept the FIGO protocol. We report our experience (similar to the major part of general surgical division like GIVIO experience) and our results. W. Wood, at ASCO 1991, has indicated the role and optimal techniques for breast conservation in early breast cancer. New lines and our experience have induced us to draw up a new protocol in early breast cancer: we did not carry out Halsted mastectomy because a local invasion of muscle or muscle aponeurosis are treated with local excision and radiotherapy; if the tumour's size is more than 3 cm we did a radical mastectomy because like many authors these cancers have a worse prognosis; under 3 cm we carried out the lumpectomy with the techniques indicated by W. Wood at ASCO 91; we remove the lymph nodes of level 3 only if the axillary lymph nodes are clinically suspected. So we think the same results of local and general control with a lower morbidity are obtained; we are considering introducing neoadjuvant chemotherapy, to increase the indication for a breast conservation treatment.