Surgical Experience with Preoperative Irradiation for Carcinoma of the Breast*

Breast Cancer

“…Local control is achieved in approximately 60% of patients with T3 and T4 tumors by using doses between 60 Gy and 70 Gy, and in 75% to 80% of cases by using higher doses (15). In many cases, tumor regression is so pronounced that cases which initially are technically inoperable become operable (16)(17)(18). In local recurrence on the chest wall following mastectomy, or in the regional lymph nodes, there is a substantial risk for new recurrence after surgical excision alone ( 1 9).…”

“…-that in patients with locally advanced, inoperable disease, radiotherapy can lead to sufficient tumor regression for patients to become operable and potentially curable (15)(16)(17)(18);…”

The Biologic Aspects of Cancer of the Breast: A Challenge*

“…At present at M.D. Anderson Hospital, radical mastectomy is still the treatment of choice in operable cases for those outer‐quadrant lesions showing clinical evidence of spread to the axillary lymph nodes, and meeting the criteria of operability so far as the primary breast lesion is concerned (3, 26, 27, 31, 34–36, 38, 45, 59, 74, 75). Super‐radical procedures are not regarded with enthusiasm and are not a standard routine practice for our surgeons.…”

“…Dr. Edgar White (74, 75), Chief of Surgery, in a 1969 review of 982 cases of carcinoma of the breast, reported that radical mastectomy (283 cases) was performed when the primary lesion was located in an outer quadrant of the breast. Postoperative irradiation was not added if the axillary nodes were free of metastasis.…”