Long-Term Results of a Randomized Trial Comparing Breast-Conserving Therapy With Mastectomy: European Organization for Research and Treatment of Cancer 10801 Trial

Reviewers: Li Liu, MD
Source: Journal of the National Cancer Institute, Volume 92(14):1143-1150, (July) 2000

Précis: Survival is similar after mastectomy, breast-conserving therapy for stage II tumors

Introduction

It has been well established that either radical mastectomy or breast-conserving therapy results in the same long-term survival and local control in women with early-stage breast cancer (i.e., tumors ? 2cm). Several studies have suggested that breast-conserving therapy might also be effective in patients with stage II tumors larger than 2 cm (New England Journal of Medicine, 1989; Mar 30;320(13):822-8), but that research has had limitations. In this study, researchers reviewed long-term follow-up data on patients with stage II breast cancer in the European Organization for Research and Treatment of Cancer Breast Cancer Cooperative Group trial.

Method

A total of 868 eligible patients, of whom 80% had tumor 2.1 cm to 5.0 cm in size had been randomly assigned to undergo either breast-conserving therapy or radical mastectomy. Ten-year follow-up analysis was performed.

Results

After a median follow-up of 13.4 years,

• Overall survival rate and the distant metastasis-free survival rate were not statistically different between the two groups at 10 years.
• There was a significantly higher rate of locoregional recurrence in the breast-conserving therapy group.

Discussion

In the study, breast-conserving therapy and radical mastectomy gave similar survival rates in women with breast cancers larger than 2.0 cm. Although the locoregional recurrence rate was higher in the breast-conserving therapy group, the number of locoregional recurrences was small in both treatment arms relative to the number of distant recurrences.