THE THESIS of this symposium implies that advanced cancer of the breast should be treated in a different manner than is cancer in the usual case of cancer of the breast. This immediately poses two questions: "What is advanced carcinoma of the breast?" and "How must the surgical procedure be altered in order to treat it adequately?"
I shall consider a lesion advanced cancer when there is lymphatic metastasis present or when the skin is involved or when there is fixation to the fascia. Lesions with distant metastasis to bone or lung will be considered hopeless. When the surgical treatment of tumors is being discussed, those for which there is some chance of cure should be sharply separated from those which have been operated on without hope of completely removing all the cancer.
An attempt will be made to determine the kind of operation which might be considered a radical