What is the efficacy of lumpectomy in the surgical treatment of breast cancer?

Updated: Feb 13, 2019
  • Author: Mary Jo Wright, MD; Chief Editor: James Neal Long, MD, FACS  more...
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Answer

Answer

The National Surgical Adjuvant Breast and Bowel Project’s B-06 (NSABP-B06) was a landmark study that established breast-conserving surgery with radiation therapy to be equivalent to modified radical mastectomy. This was a prospective trial in which 2163 breast cancer patients were randomized to modified radical mastectomy (the standard of care at that time), lumpectomy and whole-breast radiation therapy, or lumpectomy without radiation. All patients underwent axillary lymph node dissection.

At 20-year follow-up, no significant difference was seen in overall survival, disease-free survival, or distant disease-free survival among the 3 treatment groups. However, the researchers did find a significant difference in the rate of local recurrence between the 3 treatment arms.

Patients in the group that received therapy with lumpectomy alone without radiation had a significantly higher local recurrence rate (39.2%) than patients undergoing lumpectomy plus radiation therapy (14.3%). Patients who underwent modified radical mastectomy had a 10.2% risk of chest wall recurrence. [4]


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