ABSTRACT
For many women with stage I or II breast cancer, the combination of partial mastectomy and radiation therapy – together referred to as breast-conserving therapy (BCT) – is preferable to total mastectomy because BCT produces survival rates equivalent to those after total mastectomy while preserving the breast 1 . Six prospective randomized trials have shown that overall and disease-free survivals are similar with BCT and mastectomy ( Table 13.1 ) 2-7 . These same studies also evaluated local recurrence rates; four found that local recurrence rates were similar for BCT and mastectomy, and two showed higher local recurrence rates with BCT ( Table 13.2 ). However, in the two of these three studies showing higher recurrence rates with BCT, the criteria for histologically negative margins were not clear. Recent data from the Early Breast Cancer Trialists' Collaborative Group 9 showed that avoidance of local recurrence translates into a survival advantage. BCT is considered oncologically equivalent to mastectomy.
