Elena Alexandrova, Sonya Sergieva, Ana Saint Georges, Dimiter Katsarov, Margarita Taushanova, George Kalaidjiev and Angel Milev
Purpose: The aim of this clinical study was to compare breast-conserving therapy (BCT) and radical mastectomy (RM) in the treatment of early breast cancer. Materials and methods: From March 1986 to the end of 1989, 117 women with a breast tumor of up to 2 cm in size were included in this study; 66 women had a quadrantectomy, while 51 had a radical mastectomy. Full axillary dissection was performed in all patients, while adjuvant chemotherapy with cyclophosphamide, methotrexate and fluorouracil was conducted in node-positive patients. Radiation to the remaining breast parenchyma consisted of external-beam therapy, with or without regional irradiation, without boost to the tumor bed. Results: The follow-up of patients in the two treatment groups was limited to 240 months. The mean period of observation (SD±) was 201.34 months (54.12 ± 226.5) for the patients with breast-conserving therapy (BCT) and 195.84 months (35.1 ± 226.5) for the patients with radical mastectomy. No significant difference in overall survival (p=0.5410), distant metastases (Chi-Square tests, p=0.117) and contralateral breast cancers (Chi- Square Tests, p=0.809) between the two groups was established. The average survival for patients in both study groups was also statistically insignificant (211.4 months with 95% Confidence Interval 197.9*224.9 in the quadrantectomy group and 204.0 months with 95% Confidence Interval 188.0*219.9 in the radical mastectomy group, Log Rank, p=0.342). Conclusion: Our data support the view that breast-conserving surgery and irradiation is equivalent to mastectomy in terms of long-term survival for patients with stage I breast cancer.
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