Criteria of Operability in Advanced Breast Cancer

Abstract

Radical resection of the breast, pectoral muscles, and regional lymph nodes for breast cancer was popularized by William S. Halsted late in the nineteenth Century, and became the mainstay for treat-ment. The lack of benefit from this Operation for some patients was first appreciated by Haagensen who, in classic publications with Stout in 1942 and 1943, described clinical features that were predictors of a shortened life expectancy after radical mastectomy (Haagensen and Stout 1942, 1943). Based on a series of 640 patients treated by radical mastectomy, they defined what they called “specific criteria of clinical inoperability” in patients who were considered technically resectable at the time of initial clinical presentation but who experienced early recurrence after surgery. Haagensen and Stout concluded from their thoughtful analysis that other treatment strategies for the management of these patients with locally more advanced breast cancer had to be found.