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 fut ure of treating especially early cancers, extending the indications to a local conservative treatment of the breast with a more and more eff icient general treatment. The GIVIO work has proved that the major par t of Italian surgeons and gynaecologist don't accept the FIGO protocol . We report our experience (similar to the major part of general surgi cal division like GIVIO experience) and our results. W. Wood, at ASCO 1991, has indicated the role and optimal techniques for breast conserv ation in early breast cancer. New lines and our experience have induce d us to draw up a new protocol in early breast cancer: we did not carr y out Halsted mastectomy because a local invasion of muscle or muscle aponeurosis are treated with local excision and radiotherapy; if the t umour's size is more than 3 cm we did a radical mastectomy because lik e many authors these cancers have a worse prognosis; under 3 cm we car ried out the lumpectomy with the techniques indicated by W.Wood at ASC O 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 consid ering introducing neoadjuvant chemotherapy, to increase the indication for a breast conservation treatment.