Conservation surgery and irradiation as an alternative to mastectomy in the treatment of clinically favorable breast cancer

Abstract

The combination of conservation surgery and radiation therapy for early breast cancer is gaining acceptance as an alternative to radical mastectomy. This article reviews the results of randomized trials showing that there is no advantage to a radical mastectomy in patients with early breast cancer. In addition, the article will review multiple reports concerning the local and regional tumor control and survival of patients treated with conservation surgery and irradiation as well as a comparison of 1073 patients with TIS T1 T2 N0 N1 breast cancer treated at University of Texas (UT) M. D. Anderson Hospital between 1955 and 1980, of whom 345 were treated with conservation surgery and irradiation and 728 were treated with radical or modified radical mastectomy alone. The locoregional recurrence in the patients treated with an intact breast is 4.9%, and 5.6% in patients treated with radical or modified radical mastectomy. There is no significant difference in the 10-year disease-free survival rates between the two groups of patients. In addition, a comparison of 2467 patients with Stage I and Stage II breast cancer treated at the UT M. D. Anderson Hospital shows no significant difference in the incidence of consecutive second breast carcinoma as a result of the use of radiation therapy in the treatment of the first breast cancer.