Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial.

Abstract

BACKGROUND:

Breast-conserving therapy (BCT) has been shown to be as effective as mastectomy in the treatment of tumors 2 cm or smaller. However, evidence of its efficacy, over the long term, in patients with tumors larger than 2 cm is limited. From May 1980 to May 1986, the European Organization for Research and Treatment of Cancer carried out a randomized, multicenter trial comparing BCT with modified radical mastectomy for patients with tumors up to 5 cm. In this analysis, we investigated whether the treatments resulted in different overall survival, time to distant metastasis, or time to locoregional recurrence.

METHODS:

Of 868 eligible breast cancer patients randomly assigned to the BCT arm or to the modified radical mastectomy arm, 80% had a tumor of 2.1-5 cm. BCT comprised lumpectomy with an attempted margin of 1 cm of healthy tissue and complete axillary clearance, followed by radiotherapy to the breast and a supplementary dose to the tumor bed. The median follow-up was 13.4 years. All P values are two-sided.

RESULTS:

At 10 years, there was no difference between the two groups in overall survival (66% for the mastectomy patients and 65% for the BCT patients; P =.11) or in their distant metastasis-free rates (66% for the mastectomy patients and 61% for the BCT patients; P =.24). The rate of locoregional recurrence (occurring before or at the same time as distant metastasis) at 10 years did show a statistically significant difference (12% of the mastectomy and 20% of the BCT patients; P =. 01).

CONCLUSIONS:

BCT and mastectomy demonstrate similar survival rates in a trial in which the great majority of the patients had stage II breast cancer.

• Authors: J A van Dongen, A C Voogd, I S Fentiman, C Legrand, R J Sylvester, D Tong, E van der Schueren, P A Helle, K van Zijl, H Bartelink
• Journal: Journal of the National Cancer Institute (J Natl Cancer Inst) Vol. 92 Issue 14 Pg. 1143-50 (Jul 19 2000) ISSN: 0027-8874 [Print] United States
• PMID: 10904087 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)

Topics

• Breast Neoplasms (pathology, radiotherapy, surgery)
• Europe
• Female
• Follow-Up Studies
• Humans
• Lymphatic Metastasis
• Mastectomy, Modified Radical
• Mastectomy, Segmental
• Middle Aged
• Neoplasm Staging
• Proportional Hazards Models
• Radiotherapy, Adjuvant
• Risk
• Survival Analysis
• Time Factors
• Treatment Outcome