MANAGEMENT OF EARLY BREAST-CANCER IN SOUTHEAST NETHERLANDS SINCE 1984

We studied changes in staging and treatment of patients with early bre ast cancer (TNM stage I and II) in eight community hospitals in southe ast Netherlands between 1984 and 1991 and related these changes to the guidelines for the management of breast cancer drawn up by the region al Breast Cancer Study Group. Since 1984, the proportion of patients t hat underwent breast-conserving therapy (local tumour excision, axilla ry dissection, and irradiation of the breast) increased from 26% to 53 %. Although the mean number of axillary lymph nodes examined by the pa thologists increased significantly, the proportion of patients with po sitive lymph nodes remained unchanged. The proportion of patients with involved axillary nodes receiving any form of adjuvant systemic thera py increased from 49% to 82%. Therapeutic policy initially varied sign ificantly from one hospital to another but gradually became more unifo rm. We conclude that, except for elderly patients, treatment of early breast cancer corresponded increasingly to the guidelines of the regio nal Breast Cancer Study Group.