Editorial

The present issue of Swiss Surgery is divided in two distinct parts, the first dealing with selective topics (part I) presented by invited speakers at the occasion of the 5th Postgraduate Course in Surgical Oncology held every two years (Basel, 16-17 April 1999). The first 5 papers describe the sequence from screening to selective axillary clearance and staging, and finally to the selection of adequate systemic therapy. The invitation to participate at screening programs results in a 29% reduction in breast cancer mortality overall. Addressing the 40-49 year age group, a significant earlier mortality reduction is expected by shortening screening intervals to 12-18 months. The explanation being that the differentiation is more rapidly progressing in this younger age group than in the older one. Without any doubt sound population based screening programs do have a prolonged effect on breast cancer prognosis (L. Tabar et al.). Earlier detection of breast cancer also means fewer involved axillary lymph nodes. The practice of systematically clearing an axilla where in 70% uninvolved nodes are removed must be seriously questioned. Palpation and imaging are inadequate in answering the qu