Treatment options in early breast cancer.

Conservative management of early breast cancer with limited surgical excision and radiotherapy is now being accepted as a viable alternative to mutilating surgical procedures. In this paper, the major steps in the historical development of conservative management are traced, and the results of the current randomized trials are summarized. An innovative method used at the University of Kansas Medical Center delivers a "boost" dose to the tumor bed with interstitial Ir-192 immediately following resection of the primary tumor mass. The results obtained in terms of local control and cosmesis with this technique are presented, and the current state of the art is discussed.