Cited by 612Breast Cancer Treatment StudiesBreast Lesions and CarcinomasEndometrial and Cervical Cancer Treatments

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Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group

Arriagada, R, Lê, M G, Rochard, F, Contesso, G·1996·Journal of Clinical Oncology

DOI 10.1200/jco.1996.14.5.1558

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Abstract

PURPOSES: A randomized trial was conducted to compare tumorectomy and breast irradiation with modified radical mastectomy. We have analyzed the patterns of failure in each arm of the trial and the prognostic factors that have an independent effect on treatment failures and overall survival. PATIENTS AND METHODS: The trial included 179 patients with breast cancer of up to 20 mm in diameter at macroscopic examination. Eighty-eight patients had conservative management and 91 a mastectomy. All patients had axillary dissection with frozen-section examination. For patients with positive axillary nodes (N+), a second randomization was performed: lymph node irradiation versus no further regional treatment. Patterns of failure were determined by a competing-risk approach and multivariate analysis. A prognostic-score was determined by multivariate analysis. RESULTS: Overall survival, distant metastasis, contralateral breast cancer, new primary malignancy, and locoregional recurrence rates were not significantly different between the two surgical groups, or between lymph node irradiation groups. Most recurrences appeared during the first 10 years. Three distinct prognostic groups were determined taking into account age, tumor size, histologic grading, and number of positive axillary nodes. CONCLUSION: Long-term results support conservative treatment with limited surgery and systematic breast irradiation as a safe procedure for the management of small breast cancers. Four easily obtainable clinical and histologic factors may be combined in a prognostic score that is highly predictive of overall and event-free survival.

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BackgroundMethod
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Authors: Arriagada, R., Lê, M. G., Rochard, F., & Contesso, G.
Affiliations: Institut Gustave Roussy (FR)
ORCID: Arriagada, R
Lê, M G
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 1996-05
Volume: 14
Issue: 5
Pages: 1558-1564
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.1996.14.5.1558
OpenAlex: W1782647475
Cited by: 612
References: 27
Citations by year: 2026: 6 · 2025: 10 · 2024: 8 · 2023: 9 · 2022: 17 · 2021: 19 · 2020: 24 · 2019: 23 · 2018: 24 · 2017: 26 · 2016: 29 · 2015: 29 · 2014: 25 · 2013: 17 · 2012: 31
FWCI: 4.04
Type: journal article
Language: en
Open access: closed
Locations: Journal of Clinical Oncology (publishedVersion)
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 › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords: early breast cancer, breast-conserving surgery, modified radical mastectomy, breast cancer radiotherapy, axillary lymph node irradiation, failure patterns, prognostic score, overall survival, locoregional recurrence, contralateral breast cancer, distant metastasis, small breast tumors
MeSH terms: Adult, Aged, Breast Neoplasms, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Risk Factors, Mastectomy, Modified Radical, Mastectomy, Segmental, Survival Analysis, Treatment Failure

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Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group

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