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Cited by 569Breast Cancer Treatment StudiesBreast Lesions and CarcinomasBreast Implant and Reconstruction

Eighteen‐year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: The National Cancer Institute randomized trial

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Poggi, Matthew M., Danforth, David N., Sciuto, Linda C., Smith, Sharon L., Steinberg, Seth M., Liewehr, David J., Menard, Cynthia, Lippman, Marc E. +2 more·2003·Cancer
DOI 10.1002/cncr.11580
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Abstract

BACKGROUND: Between 1979-1987, the National Cancer Institute conducted a randomized, prospective study of mastectomy (MT) versus breast conservation therapy (BCT) in the treatment of patients with early-stage breast carcinoma. After a median potential follow-up of 18.4 years, the authors present the updated results. METHODS: After informed consent was obtained from each patient, 237 evaluable women with clinical AJCC Stage I and Stage II breast carcinoma were enrolled on an institutionally reviewed protocol and randomly assigned to undergo modified radical MT (116 patients) or BCT (121 patients), which was comprised of lumpectomy, axillary lymph node dissection, and radiation therapy. Negative surgical margins in the lumpectomy arm were not required. The 237 randomized patients were followed for a median potential follow-up of 18.4 years. The primary endpoints were overall survival and disease-free survival. RESULTS: At a median follow-up of 18.4 years, there was no detectable difference with regard to overall survival between patients treated with MT and those treated with BCT (58% vs. 54%; P = 0.67 overall). Twenty-seven women in the BCT arm (22%) experienced an in-breast event. After censoring in-breast events in the BCT arm that were salvaged successfully by MT, disease-free survival also was found to be statistically similar (67% in the MT arm vs. 63% in the BCT arm; P = 0.64 overall). There was no statistically significant difference with regard to contralateral breast carcinoma between the two treatment arms (P = 0.70). CONCLUSIONS: After nearly 20 years of follow-up, there was no detectable difference in overall survival or disease-free survival in patients with early-stage breast carcinoma who were treated with MT compared with those treated with BCT. For BCT patients, long-term in-breast failures continued to occur throughout the duration of follow-up. There was no statistically significant difference in the incidence of contralateral breast carcinoma between the two treatment groups.

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  • Advances in radiation oncology have improved outcomes in a number of different cancers.

    “This has resulted in improved outcomes in a number of different cancers (2, 342–350).”

    From Adrenocortical carcinoma (2014) · cites this paper as [347]

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Research works printed but not linked: 4

  1. Blichert-Toft M, Rose C, Andersen JA, et al. Danish random- ized trial comparing breast conservation therapy with mas- tectomy: six years of life-table analysis. J Natl Cancer Inst Monogr. 1992;11:19 -25.
  2. Arriagada R, Le MG, Rochard F, et al. Conservative treat- ment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. J Clin Oncol. 1996; 14:1558 -1564
  3. Lichter AS, Fraas BA, Fredrickson HA, et al. Computed to- mography in treatment planning: primary breast cancer. In: Ling CC, Rogers CC, Morton RJ, editors. Computed tomog- raphy in radiation therapy. New York: Raven Press, 1983:99 - 107.
  4. Kaplan EL, Meier P. Nonparametric estimation from incom- plete observation. J Am Stat Assoc. 1958;53:457-481.

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Authors
Poggi, M. M., Danforth, D. N., Sciuto, L. C., Smith, S. L., Steinberg, S. M., Liewehr, D. J., Menard, C., Lippman, M. E., Lichter, A. S., & Altemus, R. M.
Affiliations
  • National Cancer Institute (US)
  • University of Michigan (US)
Corresponding author
Poggi, Matthew M.
ORCID
Venue
Cancer
Publisher
Wiley
Published
2003-07-14
Volume
98
Issue
4
Pages
697-702
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
DOI
10.1002/cncr.11580
OpenAlex
W1972092276
Cited by
569
References
23
Citations by year
2026: 8 · 2025: 13 · 2024: 13 · 2023: 22 · 2022: 18 · 2021: 28 · 2020: 24 · 2019: 23 · 2018: 29 · 2017: 28 · 2016: 35 · 2015: 36 · 2014: 26 · 2013: 35 · 2012: 35
FWCI
5.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Cancer (publishedVersion, public-domain)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Breast Lesions and Carcinomas
  • Health Sciences › Medicine › Surgery › Breast Implant and Reconstruction
Keywords
early breast cancer, mastectomy, breast-conserving therapy, breast-conserving surgery, modified radical mastectomy, axillary lymph node dissection, radiotherapy, overall survival, disease-free survival, long-term follow-up
MeSH terms
Adult, Breast Neoplasms, Carcinoma, Female, Follow-Up Studies, Humans, Lymph Node Excision, Mastectomy, Middle Aged, Neoplasm Recurrence, Local, Mastectomy, Segmental, Survival Rate, Disease-Free Survival

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