Effects of radiotherapy and surgery in early breast cancer: an overview of the randomized trials

Article Abstract:

Some therapies for breast cancer, such as surgery with radiation or extensive breast surgery, may be more effective than other treatments in preventing relapse but no more effective in prolonging survival. Researchers reviewed the results of clinical trials of treatments for early breast cancer, in which all visible disease can be removed. In 36 trials death rates were similar among women who received radiotherapy with surgery versus surgery alone. However, recurrences happened in 38% of the women who received radiotherapy and 46% of the women who only had surgery. In 10 trials comparing less extensive with more extensive surgery there were no significant differences in mortality or recurrence. In nine trials comparing mastectomy with conservative surgery plus radiotherapy, there were no significant differences in mortality or relapse. Eight trials comparing axillary clearance with radiotherapy had similarly inconclusive results.

Mastectomy

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Radiotherapy after breast-preserving surgery in women with localized cancer of the breast

Article Abstract:

Breast cancer patients who receive radiation therapy after a quadrantectomy may be less likely to have local cancer again than those who do not. A quadrantectomy is a conservative type of surgery used to treat patients with localized breast cancer. Among 567 women with localized breast cancer who had a quadrantectomy combined with dissection of the nodes under the arm, 294 had radiation therapy following surgery and 273 did not. Almost 9% of the patients who did not have radiation therapy had a local cancer recurrence, compared with 0.3% of the women who had both surgery and radiation. Of the women who did not have radiation therapy, women over 55 years old were less likely to have a local recurrence than those who were 55 years old or younger. The two treatment groups had similar four-year survival rates.

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A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer

Article Abstract:

A sentinel lymph node biopsy can be very accurate in determining whether breast cancer has spread to the lymph nodes in the armpits, according to a study of 516 women with breast tumors less than one inch in diameter. After surgery to remove the tumor, half the women had their lymph nodes removed and half only had them removed if the sentinel lymph node was cancerous. Among the women whose sentinel lymph node was not cancerous, none developed lymph node cancer over an average follow-up of four years.

Diagnosis, Development and progression, Lymph nodes, Lymphatic metastasis, Lymph node biopsy

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