title: The breast cancer conundrum.
abstract: The rate of survival for patients with breast cancer is determined by the interaction of the tumor spread and the tissue ablated by the method. Clinical estimates of tumor spread are grossly inaccurate. Therefore the rate of survival is an unreliable index of the quality of the method, and a comparison of survival rates is not likely to reveal which method is superior. Nevertheless, the cancer arises in the breast, spreads away from the breast, cannot be accurately staged, and must be totally eradicated for the achievement of cure. The principle of treatment is therefore the ablation of the primary tumor and the largest amount of adjacent expendable tissue at the earliest time. Compliance of the method with this principle will produce the best possible result. Superior therapy is evidenced by compliance of the method with the principle of treatment rather than by a comparison of the rates of survival.
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans