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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
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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“This has resulted in improved outcomes in a number of different cancers (2, 342–350).”
From Adrenocortical carcinoma (2014) · cites this paper as [342]
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BackgroundMortalidad y recaída en pacientes con cáncer de mama infiltrante sometidas a cirugía conservadora
Ángel, J., Mejía, A., Guzmán, L., Quevedo, J., Sánchez, R., García, O., Duarte, C., Díaz, S., García, M., & Lehmman, C. (2014) · Revista Colombiana de Cancerología · doi:10.1016/j.rccan.2014.09.002 · Cited by 1
The William Beaumont Hospital Technique of Interstitial Brachytherapy
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Partial Breast Radiation Therapy
Beitsch, P. D., & Wilkinson, J. B. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1145-5_27 · Cited by 1
Carrillo, J. M. D. L., Jiménez, C. D., Parga, G. D. C., Vargas, I. A., Torres, P. R., Rodríguez, M. J. C., Cala, C. G., Casal, M. E. D., Sánchez, M. J. S., Domínguez, R. G., et al. (2016) · Revista de Senología y Patología Mamaria · doi:10.1016/j.senol.2016.10.005 · Cited by 1
Locoregional Recurrence After Mastectomy
Wapnir, I., Tsai, J., & Aebi, S. P. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-35955-9.00061-1 · Cited by 1
Overview of Radiation Oncology Evaluation and Management of Breast Tumors
Adams, T. C., Serrano, N. A., Chipko, C., & Arthur, D. W. (2017) · Springer eBooks · doi:10.1007/978-3-319-57726-5_5 · Cited by 1
Vingiani, A., & Viale, G. (2017) · Springer eBooks · doi:10.1007/978-3-319-48848-6_16 · Cited by 1
The Role of Radiotherapy in Breast Cancer Management
Heimann, R. (2010) · Springer eBooks · doi:10.1007/978-3-540-69743-5_16 · Cited by 1
Chadha, M. (2008) · Medical radiology · doi:10.1007/978-3-540-77385-6_8 · Cited by 1
An Updated Review on the Early Detection and Drug Development Targeting Breast Cancer
Barbhuiya, P. A., Arman, S., Paul, H., Sen, S., Dey, B. K., & Pathak, M. P. (2023) · Current Women s Health Reviews · doi:10.2174/1573404820666230713110902 · Cited by 1
Breast Cancer and Reduction Mammoplasty
Jansen, D. A., Ghere, M. C., Lee, M. A., & Jansen, M. O. (2009) · Springer eBooks · doi:10.1007/978-3-540-89873-3_88 · Cited by 1
Radioterapia adyuvante en el cáncer de mama
Marsiglia, H. R., Widakowich, C., & Rivera, R. (2004) · Oncología (Barcelona) · doi:10.4321/s0378-48352004000600011 · Cited by 1
A Review of Local and Systemic Therapy in Breast Cancer
Aydıner, A., Şen, F., Karanlık, H., Aslay, I., Dinçer, M., & İğci, A. (2016) · Springer eBooks · doi:10.1007/978-3-319-26012-9_44 · Cited by 1
Long-term community-based results of breast-conserving therapy in early-stage breast cancer
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Breast Cancer Surgery: Standard Principles
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Breast Conserving Therapy for Invasive Breast Cancers
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Metadata
- Authors
- Arriagada, R., Lê, M. G., Rochard, F., & Contesso, G.
- Affiliations
- Institut Gustave Roussy (FR)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 1996-05
- Volume
- 14
- Issue
- 5
- Pages
- 1558-1564
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- 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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