A retrospective review is presented of 1,942 consecutive patients with histopathologically confirmed invasive breast cancer, who where treated radically in Oslo from 1980 to 1989, either at General Municipal Hospitals (MH) or at a national Comprehensive Cancer Center (CC). The treatment and outcome were related to accepted medical parameters and the responsible hospital category. The median number of axillary lymph nodes described at the MH was 8, compared to 14 at the CC. During the period 1984 to 1986, 62% of the patients had an estrogen receptor analysis (MH 60%, CC 85%). Of the patients with N > or = 4, 36% received adjuvant hormone treatment (MH 32%, CC 67%), whereas the comparable percentage of patients with pT3/pT4 was 53%. The five- and ten-year cancer-related survival rates were 83% and 71% respectively, with no difference between the MH and the CC. As nation-wide criteria for the management of breast cancer have been accepted, compliance and monitoring by surgeons, pathologists and oncologists is imperative as part of quality assurance.