Breast carcinoma and surgical treatment. Results from randomized studies.
Few randomized studies including a sufficient number of patients comparing different methods of loco-regional treatment have been performed on operable breast carcinoma. This review summarizes the findings after total mastectomy with or without lymph-node dissection and/or radiotherapy. There was no difference in survival or local recurrence rates between extended radical mastectomy and radical mastectomy or mastectomy plus loco-regional radiotherapy. The results after radical mastectomy with or without loco-regional radiotherapy are the same as after modified radical mastectomy. Simple mastectomy plus loco-regional radiotherapy offers the same prospects of survival as modified or radical mastectomy with or without loco-regional radiotherapy. In some studies loco-regional radiotherapy after various forms of total mastectomy reduced loco-regional recurrences, but did not affect overall survival. Preoperative radiotherapy seems to enhance survival prospects after modified radical mastectomy, but only time will tell if this effect will be sustained.
D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008408:Mastectomy / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D011897:Random Allocation