Document Detail

Mastectomy versus breast-conserving therapy in the treatment of stage I and II carcinoma of the breast: a randomized trial at the National Cancer Institute.
MedLine Citation:
PMID:  1588378     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Mastectomy versus excisional biopsy (lumpectomy) plus radiation for the treatment of stage I and II breast cancer was compared in a prospective randomized study. PATIENTS AND METHODS: From 1979 to 1987, 247 women were randomized and 237 were treated on this study. All patients received a full axillary dissection and all node-positive patients received adjuvant chemotherapy with cyclophosphamide and doxorubicin. Radiation consisted of external-beam therapy to the whole breast with or without supraclavicular nodal irradiation followed by a boost to the tumor bed. RESULTS: The minimum time on the study was 18 months and the median time on the study was 68 months. No differences in overall survival or disease-free survival were observed. Actuarial estimates at 5 years showed that 85% of mastectomy-treated patients were alive compared with 89% of the lumpectomy/radiation patients (P2 = .49; 95% two-sided confidence interval [CI] about this difference, 0% to 9% favoring lumpectomy plus radiation). The probability of failure in the irradiated breast was 12% by 5 years and 20% by 8 years according to actuarial estimates. Of 15 local breast failures, 14 were treated with and 12 were controlled by mastectomy; the ultimate local-regional control was similar in both arms of the trial. CONCLUSION: These data add further weight to the conclusion that breast conservation using lumpectomy and breast irradiation is equivalent to mastectomy in terms of survival and ultimate local control for stage I and II breast cancer patients.
A S Lichter; M E Lippman; D N Danforth; T d'Angelo; S M Steinberg; E deMoss; H D MacDonald; C M Reichert; M Merino; S M Swain
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  10     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-06-25     Completed Date:  1992-06-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  976-83     Citation Subset:  IM    
Division of Cancer Treatment, National Cancer Institute, Bethesda, MD.
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MeSH Terms
Breast Neoplasms / mortality,  pathology,  radiotherapy,  surgery*
Chemotherapy, Adjuvant
Combined Modality Therapy
Mastectomy, Segmental*
Mastectomy, Simple*
Middle Aged
Prospective Studies
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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