[Skip to Navigation]
April 1997

Invited Commentary

Author Affiliations

North Shore University Hospital Manhasset, NY

Arch Surg. 1997;132(4):423. doi:10.1001/archsurg.1997.01430280097015

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This article explores the change in use of breast-conserving surgery in patients with stage I or II breast cancer in western Washington. The premise of the study is that the 1990 National Institutes of Health (NIH)-sponsored Consensus Development Conference may have changed the policies of surgeons during a period from January 1, 1983, to December 31, 1993. The Conference recommended breast-conserving surgery as the preferred treatment over mastectomy for women with stage I or II disease.

This study1 underscores a number of interesting patterns in the United States. Foremost is the underuse of breast-conserving surgery despite multiple studies demonstrating equivalent survival to mastectomy and despite the recommendations from the NIH Consensus Development Conference that breast-conserving surgery be used because of improved psychological outcome and no difference in survival. Even the present report, which shows increased use of breast-conserving surgery in the western Washington area, reported only a rate of

First Page Preview View Large
First page PDF preview
First page PDF preview