4.3 Breast-conserving Surgery and Case Analysis
Since Halsted reported on breast cancer in 1894，the technique has been the standard technique of breast cancer surgical treatment for more than half a century.In the 1950s，some scholars considered the tumor in the inner or central part of the breast to the endolactic lymph nodes metastasis，and thereforeput forward the need to“extensive radical resection”，and later，with the understanding of the biological properties of breast cancer itself and the law of metastasis，since the 1970s，the breast muscle retention of the“breast cancer modified radical mestectomy”developed.With Fisher and others proposed to retain breast surgery can achieve similar effects as the radical surgery，breast preservation surgery has occupied an important position in breast cancer surgical treatment，and has become the mainstream of surgical treatment in Europe and the United States.
The first breast cancer preservation surgery was seen in 1954，when Muskallio first reported on the treatment of partial resection and radiotherapy for breast cancer，which was more common in patients whose armpits did not touch the swollen lymph nodes.(https://www.daowen.com)
Hayward compared the breast partial excision and radiotherapy with the classical breast cancer treatment，and the results showed that there was no significant difference in the 10-year survival rate of the two groups in patients with stage I breast cancer，but the prognosis of the partial lycation group in stage II breast cancer was poor.Veronesi compared 701 cases of T1NO breast cancer loyalists with breast quadratic excision，armpit lymph node sweep，breast radiotherapy and classic breast cancer treatment，and found no difference between the two groups in terms of 10-year survival rate and local recurrence rate，which concluded that breast retention surgery in early breast cancer patients was safe.Fisher then compared 1843 clinical I，Ⅱ breast cancer patients with partial tumor excision，armpit lymph node sweeping，breast radiotherapy or patients who received simple mastectomy and armpit lymph node sweeping found that the 5-year survival rate was no different，but the recurrence rate in the non-radiation group was as high as 27.8%，so the tumor partial excision and armpit lymph node sweeping treatment were proposed.In recent years，breast preservation surgery has gradually become a major surgical procedure for breast cancer surgery.
Breast retention surgery should strictly grasp the surgical adaptation certificate，the choice of case will directly affect the efficacy and the preservation of breast-shaped beauty effect.