Breast-conserving surgery followed by whole-breast irradiation offers survival benefits over mastectomy without irradiation
- Resource Type
- Authors
- Yvette Andersson; Leif Bergkvist; J. de Boniface; Jan Frisell
- Source
- The British Journal of Surgery
- Subject
- Adult
medicine.medical_specialty
medicine.medical_treatment
Breast surgery
Breast Neoplasms
030230 surgery
Mastectomy, Segmental
03 medical and health sciences
0302 clinical medicine
Breast cancer
Whole Breast Irradiation
Risk Factors
medicine
Breast-conserving surgery
Humans
Prospective Studies
Prospective cohort study
Survival rate
Aged
Sweden
business.industry
Kirurgi
Carcinoma, Ductal, Breast
Original Articles
Middle Aged
Sentinel node
medicine.disease
Survival Analysis
Tumor Burden
Surgery
030220 oncology & carcinogenesis
Female
Radiotherapy, Adjuvant
Original Article
Breast Carcinoma In Situ
Neoplasm Recurrence, Local
business
Mastectomy
- Language
- English
Background The prognostic equivalence between mastectomy and breast‐conserving surgery (BCS) followed by radiotherapy was shown in pivotal trials conducted decades ago. Since then, detection and treatment of breast cancer have improved substantially and recent retrospective analyses point towards a survival benefit for less extensive breast surgery. Evidence for the association of such survival data with locoregional recurrence rates is largely lacking. Methods The Swedish Multicentre Cohort Study prospectively included clinically node‐negative patients with breast cancer who had planned sentinel node biopsy between 2000 and 2004. Axillary lymph node dissection was undertaken only in patients with sentinel node metastases. For the present investigation, adjusted survival analyses were used to compare patients who underwent BCS and postoperative radiotherapy with those who received mastectomy without radiotherapy. Results Of 3518 patients in the Swedish Multicentre Cohort Study, 2767 were included in the present analysis; 2338 had BCS with postoperative radiotherapy and 429 had mastectomy without radiotherapy. Median follow‐up was 156 months. BCS followed by whole‐breast irradiation was superior to mastectomy without irradiation in terms of both overall survival (79·5 versus 64·3 per cent respectively at 13 years; P
Radiotherapy to lower axilla key?