T1 G1 NO ER positive breast cancer--adjuvant therapy is needed.
OBJECTIVE
To assess the outcome of treating patients with excellent prognosis (T1 G1 N0 ER +ve) breast cancers with breast conserving surgery alone.


METHODS
One hundred and twenty-one women with grade 1, node negative, ER+ tumours, smaller than 20 mm who were treated by breast conserving surgery alone between 1991 and 2000. Margin width was always at least 5 mm. The following were recorded: local recurrence (LR), distant recurrence, new contra-lateral primaries and death. Recurrence rates were then compared to those in the largest series.


RESULTS
One hundred and twenty-one women were followed up for a median of 68 months. Fourteen developed further breast cancer in the same side and eight new cancers in the contra-lateral breast. There was one case of distant metastasis and no deaths. Local recurrence rate was significantly higher than other studies (p=0.006).


CONCLUSIONS
Although there is no detrimental effect on survival after this length of follow-up, the omission of radiotherapy and tamoxifen appears to increase the probability of LR. Patients with T1 G1 N0 ER+ breast cancer treated by breast conserving surgery should be offered both radiotherapy and tamoxifen.
Kirkby-Bott
J
J
The Breast Unit, Department of Breast Surgery, Royal Surrey County Hospital, Guildford, Surrey GU2 5XX, UK. jameskirby@rcsed.ac.uk
Cunnick
G
G
Kissin
M W
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome