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To the Editor.—
Cancer of the breast is newly diagnosed in approximately 90,000 patients per year in the United States, and the long-standing debate continues as to the relative merits of various therapeutic approaches. Often lost in this swirl of controversy over treatment has been the need for a deliberate effort to approach the total patient from the onset. Whereas many examples could be cited within the field of oncology, cancer of the breast serves as an eloquent illustration of this point.Consider the standard sequence of events when a woman is found to have a breast mass, whether on selfexamination or by her physician. A biopsy is scheduled with the greatest of dispatch, and when frozen-section histologic examination confirms a diagnosis of cancer, some form of mastectomy is immediately performed. For the moment, the majority of surgeons have an understandable preference for the traditional radical mastectomy, since unequivocal documentation
Johnson RE. Diagnosis of Breast Cancer. JAMA. 1974;230(10):1387–1388. doi:10.1001/jama.1974.03240100017012
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