Selection and Technique for Lumpectomy

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Abstract
The performance of a proper lumpectomy requires balancing the features required for cancer control against those for best cosmesis. Certain caveats have been established by custom without evaluation of their true importance. These include the need for clear margins, concerns for any extensive component of duct carcinoma-in-situ (DCIS), and the size of the primary tumor. Surveys of present clinical practice indicate that lumpectomy has not replaced mastectomy as the common operation for breast cancer in most centers. This suggests an incorrect understanding of the relation of lumpectomy or mastectomy to distant treatment failures, and also of the importance of local tumor control as a factor in the selection of primary treatment.