MASTECTOMY IN SMALL BREAST CANCERS

The indications of mastectomy as opposed to the conservative surgery u sually performed in patients with small breast cancers are discussed. They include true multifocal tumors, technical limitations, contraindi cations to radiation therapy (which is an indispensable adjunct to con servative surgery), and above all suspected multifocal tumors or resid ual tumor after partial excision. In these situations, it is of paramo unt importance to obtain high quality imaging and cytologic studies an d to follow strict rules for surgical sampling. When there is a strong suspicion of residual tumor, there are a number of alternatives to to tal mastectomy, which are detailed herein. The place of extemporaneous examination is discussed.