Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/5/84; site aecom.UUCP Path: utzoo!decvax!linus!philabs!aecom!werner From: werner@aecom.UUCP (Craig Werner) Newsgroups: net.med,net.women Subject: Breast Cancer Treatment. Message-ID: <1765@aecom.UUCP> Date: Sun, 23-Jun-85 01:57:10 EDT Article-I.D.: aecom.1765 Posted: Sun Jun 23 01:57:10 1985 Date-Received: Tue, 25-Jun-85 09:57:02 EDT Distribution: na Organization: Albert Einstein Coll. of Med., NY Lines: 57 Xref: linus net.med:1471 net.women:5650 The following study (of which I am quoting just the abstract) will probably be debated for years to come, so I thought some people on USENET might be interested, especially women ... [Notes: In the study below, Total Masectomy denotes what is also called Modified Radical Masectomy, Segmental Masectomy is also sometimes called Lumpectomy.] From the NEW ENGLAND JOURNAL OF MEDICINE Five-Year Results of a Randomized Clinical Trial Comparing Total Masectomy and Segmental Masectomy With or Without Radiation in the Treatment of Breast Cancer. In 1976, we began a randomized trial to evaluate breast conservation by a segmental masectomy in the treatment of stage I and II breast tumors 4 cm or smaller in size. The operation removes only sufficient tissue to ensure that margins of resected specimens are free of tumor. Women were randomly assigned to total masectomy, segmental masectomy alone, or segmental masectomy followed by breast irradiation. All patients had axillary disections, and patients with positive nodes received chemotherapy. Life table estimates based on data from 1,843 women indicated that treatment by segmental masectomy, with or without breast irradiation, resulted in disease-free, distant- disease-free, and overall survival at five years that was no worse than that after total breast removal. In fact, disease-free survival after segmental masectomy plus radiation was better than disease-free survival after total masectomy (P=.04), and overall survival after segmental masectomy, with or without radiation, was better than overall survival after total masectomy (P=.07 and P=.06 respectively). A total of 92.3% of women treated with radiation remained free of breast tumor at five years compared with 72.1% of those receiving no radiation (P<.001). Among patients with positive nodes, 97.9% of women treated with radiation remained tumor free (P<.001) although both groups received chemotherapy. We conclude that segmental mastectomy, followed by breast irradiation in all patients and adjuvant chemotherapy in women with positive nodes, is appropriate therapy for stage I and II breast timors 4 cm or smaller, provided that margins of resected specimens are free of tumor. (1985; 312:665-673) Bernard Fisher et al, National Surgical Adjuvant Breast Project Headquarters, Room 914, Scaife Hall, 3550 Terrace St., Pittsburg, PA 15261. [Translation and The bottom line: For small breast cancers - the best treatment is to remove just the part of breast that has the cancer, and then treat with Radiation Therapy. Therefore, it is no longer considered neccessary to remove the entire breast.] -- Craig Werner !philabs!aecom!werner "The world is just a straight man for you sometimes"