INDICATIONS FOR BREAST PRESERVING SURGERY IN TERMS OF EXCISIONALLY BIOPSIED CASES

From January 1988 to June 1993, 295 cases of primary breast carcinoma underwent radical operation following complete resection of the main gross lesions at the department. Through the histological examination of the resected specimens, we tried to determine whether residual carcinoma was present following tumor extirpation and whether indications for breast preserving surgery can be better confirmed by the conduct of excisional operation. It was confirmed that residual carcinoma was present in the periphery of the excisional operation wound in 58.3% of the cases, multifocal lesions in 10.7%, and lymph node metastasis in 29.6%. Inasmuch as the possibility of residual carcinoma is very high with lumpectomy, the standard operation method employed in this department for breast preserving surgery is comprised of quadrantectomy+Ax+plasty. However, the present study indicates that there is a possibility of residual carcinoma in 13.8% when the indication for our standard operative method is applied to cases with tumor diameter of less than 2.0cm, even if invasive lobular carcinoma, Paget's disease and E area cancers are excluded. In view of possible candidates for the breast preserving surgery and its limits, we should not neglect to obtain the full informed consent from the patient preoperatively.