Survival of breast-cancer patients with previous or subsequent neoplasms.

The authors reviewed retrospectively 1510 patients with breast cancer operated on between 1960 and 1980. They compared 1353 patients who had an isolated breast cancer (group 1) with 157 patients who also had breast cancer but had other cancers either previously or subsequently (group 2). The mean age of patients in group 2 was 2 years more than that of patients in group 1. Group 2 patients had fewer T3 tumours, more T1 tumours (TNM classification), a lower incidence of lymph-node involvement and clinically less advanced tumours than group 1 patients. Hormonal status, histologic type of tumour and surgical and adjuvant treatment were identical in both groups. The 10-year survival rate (considering death from breast cancer) was 54.6% in group 1 versus 78.1% in group 2. The overall survival rate (considering death from breast cancer or from the other cancer) was 54.1% in group 1 versus 64.5% in group 2. Survival was also better in group 2 for each clinical stage. The authors conclude that patients who have another cancer before or after the development of their breast cancer have a better survival rate than those who have isolated breast cancer with no previous or subsequent neoplasms.

Cancer of the breast: a study of 1520 consecutive patients operated on between 1960 and 1980.

A retrospective study was carried out of 1520 consecutive patients with breast cancer operated on at the Hôpital Notre-Dame in Montreal between 1960 and 1980. Age and hormonal status of the patient, and duration, size, location, histologic type and stage of the tumour were studied. The authors grouped the patients according to four types of surgical treatment: radical (487 patients), modified radical (497 patients) and simple (220 patients) mastectomies and conservative procedures (316 patients). Adjuvant treatments included radiotherapy in 60%, hormone therapy in 4.7% and chemotherapy in 6.7% of patients. Overall survival at 5, 10 and 15 years was 71.3%, 58.7% and 51.1%; in patients with stage I disease, survival rates were, respectively, 86%, 78% and 72%; rates for patients with stage II disease were 74%, 62% and 53%. The population characteristics and survival rates were similar to those reported by others. The four types of treatment did not produce significantly different survival rates in patients with stage I lesions. However, this was not the case in patients with stage II and III lesions in whom simple mastectomy (McWhirter procedure) was associated with significantly worse results. Finally, this study confirmed the prognostic importance of stage, size of the tumour and degree of axillary lymph-node involvement.