Conservative treatment versus mastectomy in the treatment of stage I and II breast cancer

ABSTRACT

Analysis of the patterns of failure for breast cancer patients who underwent modified mastectomy, or lumpectomy with axillary dissection and radiation therapy, as well as the prognostic factors that have an independent effect on treatment failures and overall survival. Sixty six patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary, dissection and radiation therapy. All patients with positive nodes received adjuvant systemic therapy. Annual mammography was an integral component of the follow-up program. Diagnostic studies for systemic disease were performed as clinically indicated. At five years, overall survival was 79% for patients assigned to mastectomy and 91% for those assigned to lumpectomy [P=0. 97]. Disease-free survival was 74% for patients assigned to mastectomy and 72% for those assigned to lumpectomy [P=0.7]. The rate of local recurrence was 8.8% after mastectomy and 12.5% after lumpectomy [P=0.92]. Breast conservation with lumpectomy and irradiation offers results at five years that are equivalent to those obtained with mastectomy