Treatment of Malignant Breast Tumors

I. The Institut's Contribution to the Definition of Factors Guiding the Choice of Treament.- A. Phase of Development.- 1. Acute Developing Growths (PEV 3).- 2. Subacute Developing Growths (PEV 2).- 3. Developing Growths (PEV 1).- B. Determining the Condition of the Lymph Nodes.- Anatomical-Pathological Methods of Examination.- 1. Macroscopic Examination and Dissection of Specimens.- 2. Immediate Histological Examination.- 3. Histological Examination After Fixing and Staining.- Classification of Breast Tumors.- C. Recurrence and Invasion of Lymph Nodes.- 1. Bone Metastases.- 2. Disseminated Metastases.- 3. Local/Regional Recurrences.- D. Metastases of Breast Cancers.- E. Other Factors Having Prognostic Value and Providing Criteria for the Orientation of Therapy.- 1. How to use the Idea of Prognosis.- 2. Histological Grading of Breast Carcinomas for Prognostic Purposes.- 3. Biochemistry.- 4. Mastography.- 5. Invasion of the Nipple.- 6. Number of Lymph Nodes Invaded.- 7. Clinical Dimensions and Radiological Dimensions.- F. Extent of Surgical Intervention.- 1. Simple Mastectomy.- 2. Mastectomy with Axillary Dissection (Patey's Technique).- 3. Radical Amputation of the Breast or Halsted's Technique.- 4. Extended Operation: Halsted + Internal Mammary Dissection.- G. The Techniques of Radiotherapy.- 1. Post-operative Radiotherapy.- 2. Pre-operative Radiotherapy.- 3. Regional Radiotherapy alone.- 4. Castration by Irradiation.- H. Hormone Therapy.- 1. Androgens.- 2. Estrogens.- 3. Progesterone.- 4. The Steroids.- 5. Combined Therapy.- I. Direct Action on the Endocrine Glands.- 1. Biological Comparison of Oophorectomy and Ovarian Irradiation.- 2. Irradiation of the Ovaries Versus Oophorectomy.- 3. Hypophysectomy.- J. Chemotherapy.- 1. Nitrogen Mustards.- 2. Antimetabolites.- 3. Products Whose Mechanism of Action Has Not Been Clearly Established.- K. Immunotherapy.- Combined Treatments.- II. Team Work-the Committee.- III. The Treatment Protocol-its Various Parts.- A. The TNM Classification.- 1. T-the Primitive Tumor.- 2. N-the Regional Lymph Nodes.- 3. M-Distant Metastases.- B. The Therapeutic Categories.- 1. Category A.- 2. Category B.- 3. Category C.- C. Techniques.- D. Therapeutic Indications.- 1. Category A.- 2. Category B.- 3. Category C.- E. Treatment of Recurrences.- 1. False Recurrences.- 2. Treatment of Distant Metastases.- 3. Special Cases.- F. Cancer during Pregnancy.- IV. Results.- References.