Two paradigms—breast cancer initially as a local and regional disease or breast cancer initially as a systemic disease—have affected the approach to detection and treatment of breast cancer throughout history. If breast cancer is a local/regional disease process, then there is a role for the surgeon in its cure. If breast cancer is a systemic disease, then surgery alone cannot cure it, and any cure must come from systemic treatments. If over time breast cancer progresses from a local disease to a systemic disease, then there may be a role for earlier detection of breast cancer.
Foster, Jr RS. Breast Cancer Detection and TreatmentA Personal and Historical Perspective. Arch Surg. 2003;138(4):397-408. doi:10.1001/archsurg.138.4.397