Breast cancer and “breast-conserving” surgery

  The surgical treatment of breast cancer has evolved from small to large and then from large to small. 1882, the treatment of breast cancer began with extensive radical mastectomy, which included the breast, pectoralis major and minor muscles and axillary lymph nodes. In the 1950s, many scholars considered that breast cancer could metastasize to the parasternal lymph nodes, so they proposed extended radical mastectomy, which involves the removal of the 2nd, 3rd, and 4th rib cartilage and the corresponding intercostal muscles on top of radical mastectomy for breast cancer. Later, after 60 to 70 years of clinical trials around the world, foreign scientists began to realize that breast cancer is a systemic disease, and extended resection cannot cure the tumor, and then there were relatively smaller surgeries, such as modified radical surgery with preservation of the pectoral muscle, and breast-conserving surgery, which has been performed in recent years, that is, only the breast cancer tumor and some surrounding normal glands and axillary lymph nodes are removed, together with other treatments. As a result, the 5-year survival rate of breast cancer patients does not decrease, but their quality of life is greatly improved and they have more confidence, which is more conducive to their return to society.  Breast-conserving surgery is very well developed in the United States and Japan. For example, in the United States, breast-conserving surgery accounts for more than 50% of the total number of breast cancer patients. In Hong Kong and Japan, 30-40% of patients choose breast-conserving surgery, but in mainland China, it is relatively poor, mainly because people have worries about this surgery.  In fact, moderate surgery is the trend of malignant tumor treatment, and now it is clear that most of the tumors are systemic diseases, except for a few early stage patients, the rest of patients cannot be cured by surgery. On the contrary, excessive treatment may bring patients physical harm and property loss.