Critical Analysis of the Treatment of Non‐palpable Breast Cancer:Toward a Less Invasive Future?

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