Carcinoma of the Breast

During the ten-year period from January 1, 1921, to December 31, 1930, there were seen on the Surgical Service of the New Haven Hospital 123 cases diagnosed as carcinoma of the breast. In the early part of this decade a number of patients were admitted to the hospital to receive some form of palliative treatment only, or to be given hospital care for their remaining few weeks of life. During the first four years, for example, there were only 17 cases admitted which presented any hope of possible benefit from radical surgery. Out of the entire group there were 49 cases which were not suitable subjects for radical surgical therapy, chiefly because of obvious general metastases. These received palliative treatment in the form of irradiation therapy, intravenous heavy metal therapy, and a few were treated by simple mastectomy for the local removal of an infected sloughing tumor. There were four cases which were diagnosed clinically as carcinoma and treated by radical mastectomies in which the pathological study of the excised material proved the tumors to be benign lesions. Six cases of proved carcinoma, for one reason or another, received palliative treatment in the form of a simple mastectomy. Of these, five lived an average of slightly longer than one year, the remaining one, a Grade I tumor with metastases to lymph nodes, lived more than five years. From 1921 to 1934 inclusive, in New Haven, the number of patients dying from cancer of the breast contrasted with the total number of cancer deaths during the same period is shown in Table I. These are divided into resident and non-resident groups. For the purpose of analysis of results we have taken all of our cases of proved carcinoma, 64 in number, which were treated by radical mastectomy. The majority of these were treated by radical surgery alone, with the exception of a very few which received a small amount of postoperative irradiation therapy. The dosages given, however, were for practical purposes negligible.