The past few years have seen a rather remarkable questioning of longaccepted forms of management of early breast cancer. New types of diagnosis, eg, mammography, have not been without problems despite a significant improvement in early detection. New types of treatment include less extensive surgery and the postoperative use of chemotherapeutic drug combinations to prevent or delay the onset of recurrences or metastases.
These new approaches are not free of controversy. Traditionalist surgeons decry the passing of the radical mastectomy, while admitting the lessened morbidity of simpler procedures. Editorial hallelujahs from organs as respected as the New England Journal of Medicine hailed the chemotherapeutic prophylaxis as a "breakthrough," though longer follow-up suggests lessened overall benefit than initially heralded. Meanwhile, arguments continue, and the early treatment of breast cancer remains controversial.
Now comes an important new work that begins with a historical perspective on early breast cancer treatment and then guides