Developments in the treatment of cancer of the breast

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In the spring of 1976, there was a development that may change the attitude of both surgeons and radiotherapists towards the primary treatment of breast cancer. This was the authorization by the National Cancer Institute of a randomized study comparing the results of treating small, Clinical Stage I breast cancers by three different methods: (1) modified radical mastectomy, (2) segmental (partial) mastectomy with axillary dissection plus radiation, and (3) segmental mastectomy with axillary dissection but without radiation.

If there had been any evidence that the survival rate following segmental resection and axillary dissection could be expected to be lower than that following modified radical mastectomy, the National Cancer Institute could not have authorized Dr. Bernard Fisher and his National Surgical Adjuvant Breast Project to conduct this trial. In fact, in the consent form that every patient must sign it is stated, “To date there is no conclusive information relative to the effectiveness of the treatments under study.” Already the details of the trial have been reported in a women’s magazine (Rosamond Campion, McCall’s, June 1976) with the result that women will soon be alerted to the fact that segmental mastectomy with or without radiation is an accepted method of treating some patients with breast cancer.

A dozen randomized or scientifically controlled studies, both in this country and abroad, have shown that in terms of survival there is no significant difference between the various combinations of simple and radical mastectomy with or without radiation. Thus there is real hope that, by . . .



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