Current treatment of breast cancer in the United States.

Breast cancer is one of the most common malignancies among women in the United States. Based on 1,150 cases operated by the author, 56% of all operable breast cancers were treated either by radical mastectomy or extended mastectomy and 44% were treated by modified mastectomy during the 5 year period from 1974-1978. However, in 1985, 20% of the patients were treated by partial mas tectomy and radical mastectomy was performed on only 5% and the rest were treated by modified radical mastectomy. These changes in the treatment of breast cancer are now being seen throughout the United States. Adjuvant chemotherapy treatment has been routinely given patients in the United States who have metastases to the regional lymph nodes for the past 10 years. Currently, CMF or CMFVP combinations of chemotherapy are the most commonly used for 9 or 12 month's duration. Some institutions use anti-estrogen (tamoxifen) as adjuvant treatment for the patient who has an estrogen receptor positive tumor. Conservative treatment of breast cancer will probably increase to 25-30% of primary breast cancers in the near future in the United States, but treatment should be determined individually.