Recurrence-free survival in patients with small breast cancer. An analysis of cancers 10 mm or less detected clinically and by screening.
OBJECTIVE
To evaluate survival of women with small breast cancers (10 mm or less in diameter) in a series almost unaffected by adjuvant medical treatment.


METHODS
Prospective study from a population who were randomly allocated to be screened by mammography.


METHODS
University Hospital.


METHODS
324 patients with breast cancers 10 mm or less in diameter who were operated on between 1978-85 (230 detected by screening, 21 interval cases and 73 from the control group).


METHODS
Recurrence free survival, recurrence rate, and breast cancer mortality alone and in relation to node involvement during a median follow up of 7 years (range 4 months-12.5 years).


RESULTS
Survival without distant metastases in life table analyses was 98.7% in 254 node negative cases and 79.3% in 30 node positive cases (p < 0.001). For the whole series survival without distant recurrence was 96.8%. There was no significant difference in recurrence free survival between cancers detected by screening and those detected clinically. Lymph nodes were involved in 9% of the 221 detected by screening compared with 20% of the 89 detected clinically (p < 0.03).


CONCLUSIONS
There was a very low risk of recurrence in small node negative breast cancers (irrespective of the method of detection) indicating that adjuvant treatment may not be necessary for patients with small node negative breast tumours. The good prognosis of these patients also implies that the need for follow up programmes must be discussed because they are probably unnecessary.
Arnesson
L G
LG
Department of Endocrinology, University Hospital, Linköping, Sweden.
Smeds
S
S
Fagerberg
G
G
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000517:prevention & control / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008403:Mass Screening; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D015996:Survival Rate