The primary management of breast cancer: is breast conservation feasible for all patients?
A consecutive series of 411 patients with primary breast cancer treated by a consistent policy of breast conservation, regardless of tumour size, location, clinical stage or histological subtype, is reported. Actuarial 5-year survival was 84% for UICC Stage I, 73% for Stage II and 47% for Stage III/IV. The incidence of local recurrence at 5 years was 13% for Stage I, 12% for Stage II, and 26% for Stage III/IV. The probability of salvage mastectomy at 5 years was 5% for Stage I, 8% for Stage II, and 15% for Stage III/IV. Of local recurrences, 40% were managed with further breast conservation. Primary treatment with breast conservation results in satisfactory local control rates, 5-year survival and cosmesis, but the prevention, diagnosis and treatment of local recurrence within the conserved breast requires further evaluation.
Barr
L C
LC
Academic Surgical Unit, Westminster Hospital, London.
Brunt
A M
AM
Goodman
A G
AG
Drury
A
A
Phillips
R H
RH
Ellis
H
H
D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011379:Prognosis; D015996:Survival Rate