Breast conservation is the treatment of choice in small breast cancer: Long-term results of a randomized trial |
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| Institution: | 1. Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Wuxi 214122, China;2. CAS Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China;3. School of Pharmacy, China Pharmaceutical University, Jiangsu, Nanjing 210009, China;4. Shanghai Key Laboratory of New Drug Design, School of Pharmacy, East China University of Science and Technology, Shanghai 200237, China;5. State Key Laboratory Cultivation Base for TCM Quality and Efficacy, School of Medicine and Life Sciences, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing 210023, China;1. Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California;2. Jonsson Comprehensive Cancer Center and Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, California;3. Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, California;4. Department of Urology, University of Washington, Seattle, Washington;1. Department of Radiation Oncology, Ramaiah Medical College and Hospital, Bengaluru, India;2. Department of Radiotherapy, Ramaiah Medical College, Bengaluru, India;1. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida;2. HIV/AIDS Section, Bureau of Communicable Diseases, Florida Department of Health, Tallahassee, Florida;3. School of Population Health, University of South Australia, Adelaide, South Australia, Australia;1. Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805 Villejuif, France;2. Departement d’Anatomie Pathologiques Recherche, Institut Universitaire du Cancer Toulouse – Oncopole, 1 Avenue Irène Joint-Curie, 31509 Toulouse Cedex 9, France;3. University Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France;4. Pathology Department, Hôpital Marie Lannelongue, 133, avenue de la Résistance, 92350 Le Plessis-Robinson, France |
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| Abstract: | From 1973 to 1980, 701 women with small breast cancer (less than 2 cm in diameter) were randomized into two different treatments. 349 patients received classic Halsted mastectomy and 352 patients received quadrantectomy, axillary dissection and radiotherapy on the ipsilateral breast. 24.6% of the patients in the mastectomy group and 27.0% of the patients in the conservation group had axillary metastases. Overall 10 year survival was 76% in the Halsted patients and 79% in the quadrantectomy patients; 13 year survival was 69% and 71%, respectively. No differences were observed after analysis by site and size of the primary tumour and age of the patients. Patients with positive axillary nodes had consistently better survival curves in the quadrantectomy group compared with the Halsted group (not significant). Among the quadrantectomy patients there were 11 local recurrences (with 4 deaths) while among the Halsted patients, 7 had local recurrences (5 deaths). There were 19 cases of contralateral breast carcinomas in the quadrantectomy group and 20 in the Halsted group. At 16 years from the beginning of the trial no evidence of oncogenic radiation risk was observed. In patients with small size carcinomas total mastectomy should have no role. |
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