Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer

Joan A. Jacobson, David N. Danforth, Kenneth H. Cowan, Teresa D'angelo, Seth M. Steinberg, Lori Pierce, Marc E. Lippman, Allen S. Lichter, Eli Glatstein, Paul Okunieff

Research output: Contribution to journalArticle

720 Citations (Scopus)

Abstract

Breast-conservation therapy for early-stage breast cancer is now an accepted treatment, but there is still controversy about its comparability with mastectomy. Between 1979 and 1987, the National Cancer Institute conducted a randomized, single-institution trial comparing lumpectomy, axillary dissection, and radiation with mastectomy and axillary dissection for stage I and II breast cancer. We update the results of that trial after a median potential follow-up of 10.1 years. Two hundred forty-seven patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection, and radiation therapy. The 237 patients who actually underwent randomization have been followed for a median of 10.1 years. The primary end points were overall survival and disease-free survival. At 10 years overall survival was 75 percent for the patients assigned to mastectomy and 77 percent for those assigned to lumpectomy plus radiation (P = 0.89). Disease-free survival at 10 years was 69 percent for the patients assigned to mastectomy and 72 percent for those assigned to lumpectomy plus radiation (P = 0.93). The rate of local regional recurrence at 10 years was 10 percent after mastectomy and 5 percent after lumpectomy plus radiation (P = 0.17) after recurrences successfully treated by mastectomy were censored from the analysis. In the management of stage I and II breast cancer, breast conservation with lumpectomy and radiation offers results at 10 years that are equivalent to those with mastectomy.

Original languageEnglish (US)
Pages (from-to)907-911
Number of pages5
JournalNew England Journal of Medicine
Volume332
Issue number14
DOIs
StatePublished - Apr 6 1995

Fingerprint

Segmental Mastectomy
Mastectomy
Breast Neoplasms
Radiation
Dissection
Therapeutics
Disease-Free Survival
Modified Radical Mastectomy
Recurrence
Survival
National Cancer Institute (U.S.)
Random Allocation
Radiotherapy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. / Jacobson, Joan A.; Danforth, David N.; Cowan, Kenneth H.; D'angelo, Teresa; Steinberg, Seth M.; Pierce, Lori; Lippman, Marc E.; Lichter, Allen S.; Glatstein, Eli; Okunieff, Paul.

In: New England Journal of Medicine, Vol. 332, No. 14, 06.04.1995, p. 907-911.

Research output: Contribution to journalArticle

Jacobson, JA, Danforth, DN, Cowan, KH, D'angelo, T, Steinberg, SM, Pierce, L, Lippman, ME, Lichter, AS, Glatstein, E & Okunieff, P 1995, 'Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer', New England Journal of Medicine, vol. 332, no. 14, pp. 907-911. https://doi.org/10.1056/NEJM199504063321402
Jacobson, Joan A. ; Danforth, David N. ; Cowan, Kenneth H. ; D'angelo, Teresa ; Steinberg, Seth M. ; Pierce, Lori ; Lippman, Marc E. ; Lichter, Allen S. ; Glatstein, Eli ; Okunieff, Paul. / Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer. In: New England Journal of Medicine. 1995 ; Vol. 332, No. 14. pp. 907-911.
@article{53e7b60cbf76409da89164f59fffca8b,
title = "Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer",
abstract = "Breast-conservation therapy for early-stage breast cancer is now an accepted treatment, but there is still controversy about its comparability with mastectomy. Between 1979 and 1987, the National Cancer Institute conducted a randomized, single-institution trial comparing lumpectomy, axillary dissection, and radiation with mastectomy and axillary dissection for stage I and II breast cancer. We update the results of that trial after a median potential follow-up of 10.1 years. Two hundred forty-seven patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection, and radiation therapy. The 237 patients who actually underwent randomization have been followed for a median of 10.1 years. The primary end points were overall survival and disease-free survival. At 10 years overall survival was 75 percent for the patients assigned to mastectomy and 77 percent for those assigned to lumpectomy plus radiation (P = 0.89). Disease-free survival at 10 years was 69 percent for the patients assigned to mastectomy and 72 percent for those assigned to lumpectomy plus radiation (P = 0.93). The rate of local regional recurrence at 10 years was 10 percent after mastectomy and 5 percent after lumpectomy plus radiation (P = 0.17) after recurrences successfully treated by mastectomy were censored from the analysis. In the management of stage I and II breast cancer, breast conservation with lumpectomy and radiation offers results at 10 years that are equivalent to those with mastectomy.",
author = "Jacobson, {Joan A.} and Danforth, {David N.} and Cowan, {Kenneth H.} and Teresa D'angelo and Steinberg, {Seth M.} and Lori Pierce and Lippman, {Marc E.} and Lichter, {Allen S.} and Eli Glatstein and Paul Okunieff",
year = "1995",
month = "4",
day = "6",
doi = "10.1056/NEJM199504063321402",
language = "English (US)",
volume = "332",
pages = "907--911",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "14",

}

TY - JOUR

T1 - Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer

AU - Jacobson, Joan A.

AU - Danforth, David N.

AU - Cowan, Kenneth H.

AU - D'angelo, Teresa

AU - Steinberg, Seth M.

AU - Pierce, Lori

AU - Lippman, Marc E.

AU - Lichter, Allen S.

AU - Glatstein, Eli

AU - Okunieff, Paul

PY - 1995/4/6

Y1 - 1995/4/6

N2 - Breast-conservation therapy for early-stage breast cancer is now an accepted treatment, but there is still controversy about its comparability with mastectomy. Between 1979 and 1987, the National Cancer Institute conducted a randomized, single-institution trial comparing lumpectomy, axillary dissection, and radiation with mastectomy and axillary dissection for stage I and II breast cancer. We update the results of that trial after a median potential follow-up of 10.1 years. Two hundred forty-seven patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection, and radiation therapy. The 237 patients who actually underwent randomization have been followed for a median of 10.1 years. The primary end points were overall survival and disease-free survival. At 10 years overall survival was 75 percent for the patients assigned to mastectomy and 77 percent for those assigned to lumpectomy plus radiation (P = 0.89). Disease-free survival at 10 years was 69 percent for the patients assigned to mastectomy and 72 percent for those assigned to lumpectomy plus radiation (P = 0.93). The rate of local regional recurrence at 10 years was 10 percent after mastectomy and 5 percent after lumpectomy plus radiation (P = 0.17) after recurrences successfully treated by mastectomy were censored from the analysis. In the management of stage I and II breast cancer, breast conservation with lumpectomy and radiation offers results at 10 years that are equivalent to those with mastectomy.

AB - Breast-conservation therapy for early-stage breast cancer is now an accepted treatment, but there is still controversy about its comparability with mastectomy. Between 1979 and 1987, the National Cancer Institute conducted a randomized, single-institution trial comparing lumpectomy, axillary dissection, and radiation with mastectomy and axillary dissection for stage I and II breast cancer. We update the results of that trial after a median potential follow-up of 10.1 years. Two hundred forty-seven patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection, and radiation therapy. The 237 patients who actually underwent randomization have been followed for a median of 10.1 years. The primary end points were overall survival and disease-free survival. At 10 years overall survival was 75 percent for the patients assigned to mastectomy and 77 percent for those assigned to lumpectomy plus radiation (P = 0.89). Disease-free survival at 10 years was 69 percent for the patients assigned to mastectomy and 72 percent for those assigned to lumpectomy plus radiation (P = 0.93). The rate of local regional recurrence at 10 years was 10 percent after mastectomy and 5 percent after lumpectomy plus radiation (P = 0.17) after recurrences successfully treated by mastectomy were censored from the analysis. In the management of stage I and II breast cancer, breast conservation with lumpectomy and radiation offers results at 10 years that are equivalent to those with mastectomy.

UR - http://www.scopus.com/inward/record.url?scp=0028962197&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028962197&partnerID=8YFLogxK

U2 - 10.1056/NEJM199504063321402

DO - 10.1056/NEJM199504063321402

M3 - Article

C2 - 7877647

AN - SCOPUS:0028962197

VL - 332

SP - 907

EP - 911

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 14

ER -