Abstract
Between 1970 and 1975, 2268 patients with clinical stages I and II breast cancer were assigned by random sample to receive either simple mastectomy plus postoperative radiotherapy or simple mastectomy followed by a watch policy, with further treatment employed only for recurrent disease. After 5 years of follow-up there is no evidence that postoperative radiotherapy increases the survival rate or decreases the incidence of distant metastases, although it is clearly advantageous in preventing local recurrence. Histological examination of the lymph nodes from the tail of the breast or pectoral region in 350 patients showed that postoperative radiotherapy did not influence survival, local recurrence or the occurrence of distant metastases in patients with negative nodes. However, in patients with positive nodes postoperative radiotherapy was associated with a decreased incidence of local recurrence, but a 10% increase in mortality rate during the first year after treatment.
Résumé
Entre 1970 et 1975, 2268 patientes atteintes d'un cancer du sein aux stades I ou II ont été sélectionnées au hasard en deux groupes: mastectomie simple suivie de radiothérapie postopératoire ou mastectomie simple avec simple surveillance postopératoire et traitement éventuel des récidives. Après 5 années d'observation, rien ne prouve que la radiothérapie postopératoire améliore la survie ou diminue la fréquence des métastases à distance, mais elle réduit le pourcentage de récidives locales. L'histologie des ganglions du prolongement axillaire de la glande mammaire ou de la région pectorale a été faite dans 350 cas. Chez les malades sans envahissement ganglionnaire, la radiothérapie est sans effet sur la survie, les récidives locales ou les métastases à distance. Chez les patientes avec métastases ganglionnaires, la radiothérapie postopératoire réduit la fréquence des récidives locales, mais accroit de 10% la mortalité pendant la première année qui suit le traitement.
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References
Management of early cancer of the breast: Report on an international multicentre trial supported by the Cancer Research Campaign. Br. Med. J.,1:1035, 1976
McDonald, A.M., Simpson, J.S., Maclntyre, J.: Treatment of early cancer of the breast: histological staging and role of radiotherapy. Lancet1:1098, 1976
Cant, E.L.M., Shivas, A.A., Forrest, A.P.M.: Lymphnode biopsy during simple mastectomy. Lancet1:995, 1975
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Financial support was supplied by the Cancer Research Campaign.
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Greig Murray, J., MacIntyre, J., Simpson, J.S. et al. Cancer research campaign study of the management of “early” breast cancer. World J. Surg. 1, 317–319 (1977). https://doi.org/10.1007/BF01556847
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DOI: https://doi.org/10.1007/BF01556847