Critical analysis of the treatment of non-palpable breast cancer: Toward a less invasive future?

Results and experience with the treatment of non-palpable breast cancer are reported and related to the future of less invasive treatment of small breast cancers. The retrospective study included 102 patients treated between 1980 and 1993 at the University Hospital of Nijmegen. Most cancers were screen-detected. Tumor sizes on pathological examination proved 3 mm (SD 7.7 mm) larger than on mammography (p = 0.0029). pT1 tumors were encountered in 77 patients (75%); pT2 tumors in 17 patients (17%). Seventy-five patients were free of lymph node metastases, 26 patients showed stage pN1 (25%). Most patients had invasive ductal cancers. Only two patients died of breast cancer. A 10-year disease-free survival of 94% was calculated, after excluding four patients with known systemic disease (M1) at diagnosis. T1a, T1b, and T1c had a 10-year survival of 100%, 96%, and 96%, respectively. Early detection and multimodality treatment of breast cancer have significantly improved survival. In patients with small breast cancer tumors future developments in treatment must be aimed at the use of less invasive techniques, reducing morbidity while maintaining high levels of disease-free survival.