Abstract
This study reports the results of a prospectively randomized trial for treatment of carcinoma of the breast comparing standard (Halsted) radical mastectomy to a modified radical mastectomy. Three hundred eleven patients with primary operable carcinoma of the breast were entered in a surgical and adjunctive chemotherapy trial in Alabama between 1975 and 1978. A total of 91 surgeons participated (all Diplomats of the American Board of Surgery and Members of the American College of Surgeons). All operative reports, pathology and therapy were reviewed by referees. Histologically node positive patients were randomized after operation to receive melphalan or C.M.F.(cytoxan, methotrexate, and 5-FU) for 1 year. After a median follow-up of 5.5 years, there was no significant difference in disease-free survival or in overall survival between the two groups. There was a trend toward improved 5-year survival rates in the radical mastectomy group compared to the modified radical mastectomy group (84% vs. 76%, p = 0.14). There was also an increased incidence of local wound recurrence in those patients receiving modified radical mastectomy, but the differences were not statistically significant (p = 0.09). Longer follow-up will be necessary to evaluate these results more fully.
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- Baker R. R., Montague A. C., Childs J. N. A comparison of modified radical mastectomy to radical mastectomy in the treatment of operable breast cancer. Ann Surg. 1979 May;189(5):553–559. doi: 10.1097/00000658-197905000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Carpenter J. T., Jr, Laws H. L., Maddox W. A. Breast cancer management: Part III. A comprehensive program for the management of breast cancer. J Med Assoc State Ala. 1975 Sep;45(3):37–46. [PubMed] [Google Scholar]
- Carpenter J. T., Jr, Maddox W. A., Laws H. L., Wirtschafter D. D., Soong S. J. Favorable factors in the adjuvant therapy of breast cancer. Cancer. 1982 Jul 1;50(1):18–23. doi: 10.1002/1097-0142(19820701)50:1<18::aid-cncr2820500105>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
- Davies G. C., Millis R. R., Hayward J. L. Assessment of axillary lymph node status. Ann Surg. 1980 Aug;192(2):148–151. doi: 10.1097/00000658-198008000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fisher B., Redmond C., Fisher E. R. The contribution of recent NSABP clinical trials of primary breast cancer therapy to an understanding of tumor biology--an overview of findings. Cancer. 1980 Aug 15;46(4 Suppl):1009–1025. doi: 10.1002/1097-0142(19800815)46:4+<1009::aid-cncr2820461326>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
- Halsted W. S. I. The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894. Ann Surg. 1894 Nov;20(5):497–555. doi: 10.1097/00000658-189407000-00075. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lacour J., Bucalossi P., Cacers E., Jacobelli G., Koszarowski T., Le M., Rumeau-Rouquette C., Veronesi U. Radical mastectomy versus radical mastectomy plus internal mammary dissection. Five-year results of an international cooperative study. Cancer. 1976 Jan;37(1):206–214. doi: 10.1002/1097-0142(197601)37:1<206::aid-cncr2820370130>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
- Madden J. L. Modified radical mastectomy. Surg Gynecol Obstet. 1965 Dec;121(6):1221–1230. [PubMed] [Google Scholar]
- Meyer A. C., Smith S. S., Potter M. Carcinoma of the breast. A clinical study. Arch Surg. 1978 Apr;113(4):364–367. doi: 10.1001/archsurg.1978.01370160022002. [DOI] [PubMed] [Google Scholar]
- Nemoto T., Vana J., Bedwani R. N., Baker H. W., McGregor F. H., Murphy G. P. Management and survival of female breast cancer: results of a national survey by the American College of Surgeons. Cancer. 1980 Jun 15;45(12):2917–2924. doi: 10.1002/1097-0142(19800615)45:12<2917::aid-cncr2820451203>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
- Patey D. H. A review of 146 cases of carcinoma of the breast operated on between 1930 and 1943. Br J Cancer. 1967 Jun;21(2):260–269. doi: 10.1038/bjc.1967.28. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Robinson G. N., van Heerden J. A., Payne W. S., Taylor W. F., Gaffey T. A. The primary surgical treatment of carcinoma of the breast: a changing trend toward modified radical mastectomy. Mayo Clin Proc. 1976 Jul;51(7):433–442. [PubMed] [Google Scholar]
- Turner L., Swindell R., Bell W. G., Hartley R. C., Tasker J. H., Wilson W. W., Alderson M. R., Leck I. M. Radical versus modified radical mastectomy for breast cancer. Ann R Coll Surg Engl. 1981 Jul;63(4):239–243. [PMC free article] [PubMed] [Google Scholar]
- Veronesi U., Saccozzi R., Del Vecchio M., Banfi A., Clemente C., De Lena M., Gallus G., Greco M., Luini A., Marubini E. Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med. 1981 Jul 2;305(1):6–11. doi: 10.1056/NEJM198107023050102. [DOI] [PubMed] [Google Scholar]
- Veronesi U., Valagussa P. Inefficacy of internal mammary nodes dissection in breast cancer surgery. Cancer. 1981 Jan 1;47(1):170–175. doi: 10.1002/1097-0142(19810101)47:1<170::aid-cncr2820470128>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]