1. Surgery of Primary Breast Cancer.- 1. Principles of Breast Cancer Surgery: From Halsted to the Present.- 2. Factors Prompting Redefinition of the Basis for Breast Cancer Surgery.- 2.1. Breast Cancer as a Systemic Disease.- 2.2. Effects of Primary Tumor Removal.- 2.3. Redefinition of the Role of Lymphatics and Lymph Nodes.- 2.4. The Significance of Multicentricity.- 3. A Biologic Basis for Cancer Surgery.- 4. An Overview of Presently Employed Operations.- 4.1. Radical Mastectomy.- 4.2. Extended Radical Mastectomy.- 4.3. Total (Simple) Mastectomy.- 4.4. Segmental Mastectomy.- 5. Considerations Regarding Special Surgical Problems.- 5.1. Page?s Disease.- 5.2. Inflammatory Carcinoma.- 5.3. Management of Noninvasive Breast Cancer.- 5.4. Management of the Uninvolved Breast.- 6. Surgery in Conjunction with Other Therapeutic Modalities.- 7. Comments and Prospects for the Future.- 8. References.- 2. Pathology of Breast Cancer.- 1. Introduction.- 2. Histologic Types of Breast Cancer.- 2.1. Infiltrating Ductal Carcinoma, Not Otherwise Specified (NOS).- 2.2. Medullary Cardinoma.- 2.3. Lobular Invasive Carcinoma.- 2.4. Mucinous Carcinoma.- 2.5. Tubular Carcinoma.- 2.6. Adenocystic Carcinoma.- 2.7. Papillary Carcinoma.- 2.8. Page?s Disease.- 2.9. Rare Cancers of the Breast.- 3. Histologic Grading.- 4. Nuclear Grading.- 5. Circumscription.- 6. Tumor Size.- 7. Cell Reaction.- 8. Stromal Change.- 9. Elastica.- 10. Mucin.- 11. Calcium.- 12. Glycogen.- 13. Squamous Metaplasia.- 14. Apocrine Change, Oxyphilia.- 15. Necrosis.- 16. Relationship of Fibrocystic Disease to Cancer.- 17. Noninvasive Cancer in the Vicinity of the Dominant Tumor.- 18. Lymphatic Invasion.- 19. Blood Vessel Invasion.- 20. Perineural Space Invasion.- 21. Multicentric Cancer and Changes in Quadrants Remote from the Primary Tumor.- 22. Nipple Involvement.- 23. Relationship of Florid Papillomatosis of the Nipple to Cancer.- 24. Involvement of Skin over the Tumor.- 25. Alterations of Regional Lymph Nodes in Breast Cancer.- 25.1. Sinus Histiocytosis.- 25.2. Significance of Regional Node Histology Other Than.- Sinus Histiocytosis.- 25.3. Nodal Status.- 25.4. Significance of Extranodal Axillary Metastases.- 26. Multiple Cancers (Dominant Masses) in the Same Breast.- 27. References.- 3. Systemic Adjuvant (Combined Modality) Therapy in the Treatment of Primary Breast Cancer.- 1. Introduction.- 2. Tumor Cell Kinetics and Adjuvant Chemotherapy.- 3. Surgical Adjuvant Therapy in Animal Model Systems.- 4. Early Trials of Systemic Adjuvant Therapy.- 5. Recent and Present Trials of Systemic Adjuvant Therapy.- 5.1. L-PAM Protocol.- 5.2. CMF Protocol.- 5.3. Additional NSABP Protocols.- 5.4. Other Adjuvant Chemotherapy Trials.- 5.5. Trials of Immunotherapy.- 6. Comments and Speculations.- 7. References.- 4. Combination Chemotherapy for Advanced Disease.- 1. Introduction.- 1.1. Background.- 1.2. Natural History of Advanced Breast Cancer Relative to Chemotherapy Response.- 2. Experimental Background of Chemotherapy of Breast Cancer.- 2.1. Cell Cycle and Chemotherapy.- 2.2. Cell Kinetics.- 2.3. Growth Rates of Human Breast Cancers.- 2.4. Animal Models.- 3. Pharmacology.- 4. Clinical Evaluation of Drugs.- 5. Combinations.- 5.1. Relative Activity Compared to Single Agents.- 5.2. Maximizing Effects of Combinations.- 5.3. The Concept of Alternating Combinations.- 5.4. Useful Combinations.- 5.5. The Role of Adriamycin in Combinations.- 5.6. Response Duration and Survival.- 6. Chemotherapy and Hormonal Therapy.- 7. Immunotherapy.- 8. The Changing Role of Chemotherapy in Breast Cancer Treatment.- 9. Special Problems.- 9.1. Hypercalcemia.- 9.2. Central Nervous System (Brain, Meninges).- 9.3. Pulmonary.- 9.4. Bone Marrow Failure.- 9.5. Effusions.- 9.6. Inflammatory Cancer.- 9.7. Long-Term Effects of Chemotherapy.- 10. The Future of Chemotherapy.- 10.1. New Drugs.- 10.2. Developing Approaches.- 10.3. Selectivity.- 10.4. Monitoring.- 11. References.- 5. Physiological Principles Underlying Endocrine Therapy of Breast Cancer.- 1. Introduction.- 2. Prolactin.- 2.1. Rat Mammary Tumors.- 2.2. Human Breast Cancer.- 2.3. Mechanism of Prolactin Dependence.- 3. Estrogen.- 3.1. Localization of Estrogens in Responsive Tumors.- 3.2. Measurement of Estrogen Receptor.- 3.3. Rat Mammary Tumors as a Model System.- 3.4. Estrogen Receptor in Human Breast Tumors.- 3.5. Antiestrogens.- 3.6. Systemic Approaches to Reducing Estrogen Production.- 4. Progesterone.- 4.1. Clinical Effects in Breast Cancer.- 4.2. Subcellular Metabolism of Progesterone.- 4.3. Progesterone Receptors.- 4.4. Progesterone Interrelationship with Other Steroid Hormones.- 4.5. Progesterone Receptors in Human Breast Cancer.- 5. Glucocorticoids.- 6. Androgens.- 6.1. Androgens in Mammary Carcinoma.- 7. Conclusions.- 8. References.- 6. The Changing Role of Radiation Therapy in Breast Cancer: A Study in Therapeutic Controversy.- 1. Introduction.- 2. Stage I.- 2.1. The Controversy.- 2.2. Indications for Treatment.- 2.3. Technique of Treatment.- 3. Stage II.- 3.1. The Controversy.- 3.2. Indications for Radiation Therapy.- 3.3. Techniques of Treatment.- 4. Stage III.- 4.1. The Controversy.- 4.2. Inflammatory Carcinoma.- 4.3. Indications for Treatment.- 4.4. Radiation Therapy Techniques, Doses, and Treatment Plans.- 4.5. Studies Under Way and Future Protocols Needed.- 5. Stage IV.- 5.1. The Controversy.- 5.2. Indications for Irradiation.- 6. Conclusions.- 7. References.- 7. Immunology and Immunotherapy of Human Breast Cancer: Recent Developments and Prospects for the Future.- 1. Introduction.- 2. Histologic Evidence for Host Immune Response.- 3. General Immune Competence.- 3.1. Delayed Cutaneous Hypersensitivity.- 3.2. Lymphocyte Counts in Breast Cancer.- 3.3. In Vitro Tests.- 4. Tumor-Associated Antigens.- 4.1. Skin-Test Assays to Detect Antigens in Breast Cancer ...- 4.2. Lymphocyte Stimulation by Breast Cancer Antigens.- 4.3. Cytotoxicity.- 4.4. Measurement of Lymphokines.- 4.5. Human Tumor Serology.- 4.6. Other Evidence for Breast Cancer Antigens.- 5. Immunological Evidence for Viral Antigens in Human Breast Cancer.- 6. Effect of Hormones on Immunity.- 7. Influence of Radiotherapy on the Immune Response.- 8. Immunotherapy.- 8.1. Local Immunotherapy.- 8.2. Active Nonspecific Immunotherapy.- 8.3. Active Specific Immunotherapy.- 8.4. Adoptive Immunotherapy.- 8.5. Immunotherapy with Lymphokines.- 8.6. Thymic Hormones in Immunotherapy.- 8.7. Passive Immunotherapy.- 8.9. Interactions of Chemotherapy and Immunotherapy.- 9. Immunoprophylaxis of Breast Cancer: Outlook for the Future.- 10. Conclusions and Prospects.- 11. References.