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January 16, 1991

Treatment of Early-Stage Breast Cancer

JAMA. 1991;265(3):391-395. doi:10.1001/jama.1991.03460030097037

Carcinoma of the breast is the most common malignant neoplasm in women in the United States. Breast cancer is exceeded only by lung cancer as a cause of cancer death in women, and its incidence has been rising steadily over the past decade. In the 1990s, more than 1.5 million women will be newly diagnosed as having this disease; nearly 30% of these women will ultimately die of breast cancer. The increased number of reported cases may be partially attributable to more widespread use of screening mammography. Most of the increase has been in patients with smaller primary breast tumors. In 1982, approximately 12 000 women were diagnosed as having tumors less than 2 cm in diameter and negative axillary lymph nodes. That number had risen to 32 000 by 1986. For those patients with axillary node—positive breast cancer, there has been a less dramatic increase in tumors under 2