Controlled trials in the treatment of "early" breast cancer: a review of published results.

Abstract

AbstractThis review summarizes the results of local treatment of “early” breast cancer obtained in 17 clinical trials that can be divided into 3 groups. In the 7 trials in group I, the type of surgery in each was a constant (radical mastectomy or simple mastectomy) and the evaluations were designed to compare the results of various forms of postoperative treatment (immediate radiotherapy, delayed radiotherapy, chemotherapy, placebo, and observation). In the 4 trials in group II, the postoperative management in each was a constant (radiotherapy or observation) and the variable that was evaluated was the type of surgery (simple mastectomy versus radical mastectomy). In the 6 trials in group III, both the type of surgery (super‐radical mastectomy, radical mastectomy, simple mastectomy, wide local excision) and the type of postoperative treatment (partial or complete radiotherapy, observation) were varied so as to evaluate different combinations. Although sufficient time has not elapsed to assess the results of many of these trials, the conclusions that appear warranted at this time are: 1) simple mastectomy combined with postoperative radiotherapy is as effective in terms of survival and recurrence rates as radical mastectomy with or without postoperative radiotherapy in stage I and stage II breast cancer, and 2) postoperative radiotherapy does not increase survival following radical mastectomy.