Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol
| Autor: | Maja Nielsen, Mogens Blichert-Toft, Maria Düring, Fritz Rank, Marie Overgaard, Susanne Møller, Henning T. Mouridsen |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Breast surgery Breast Neoplasms Mastectomy Segmental law.invention Breast cancer Randomized controlled trial law Breast-conserving surgery Humans Medicine Radiology Nuclear Medicine and imaging Survival rate Mastectomy business.industry Carcinoma Ductal Breast Hematology General Medicine Middle Aged medicine.disease Surgery Survival Rate Radiation therapy Oncology Chemotherapy Adjuvant Female Radiotherapy Adjuvant Neoplasm Recurrence Local business Breast carcinoma Follow-Up Studies |
| Zdroj: | Acta Oncologica. 47:672-681 |
| ISSN: | 1651-226X 0284-186X |
| Popis: | The main objective of the present study aims at comparing the long-term efficacy of breast conserving surgery (BCS) vs. mastectomy (M) based on a randomized design. The Danish Breast Cancer Cooperative Group (DBCG) conducted the trial (DBCG-82TM) from January 1983 to March 1989 recruiting 1154 patients with invasive breast carcinoma. Follow-up time ended 1(st) May 2006 with a median follow-up time of 19.6 years (time span 17.1-23.3 years). Eligibility criteria included a one-sided, unifocal, primary operable breast carcinoma, patient age below 70 years, probability of satisfactory cosmetic outcome with BCS, and no evidence of disseminated disease. The patients accrued were grouped into three subsets: correctly randomized, suspicion of randomization error, and declining randomization. The main analyses focus on the subgroup of 793 correctly randomized patients representing 70% of the complete series. 10-year recurrence free survival (RFS) and 20-year overall survival (OS) based on intent to treat did not reveal significant differences in outcome between breast conserving surgery vs. mastectomy, p=0.95 and p=0.10, respectively. Including the complete series comprising 1133 eligible patients based on treatment in fact given similarly no significant difference between surgical options could be traced in outcome of 10-year RFS and 20-year OS, p=0.94 and p=0.24, respectively. The pattern of recurrences as a first event in breast conservation vs. mastectomy did not differ significantly irrespective of site, p=0.27. Looking into the type of local relapse, viz., new primaries vs. true recurrences, it appeared that new primaries were significantly associated to BCS, while true recurrences dominated among M treated patients (p |
| Databáze: | OpenAIRE |
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