No survival advantage for mastectomy after 20 years. (More than 2,500 Women Studied).

Long-term survival rates among women who have undergone breast-conserving surgery and radiation therapy for early-stage disease are similar to those of women who have had mastectomies.

That finding emerged from two studies of more than 2,500 women who were followed for a median of 20 years.

"The failure to observe a survival advantage of mastectomy after 20 years should convince even the most determined skeptics that mastectomy is not superior to breast conservation for the treatment of breast cancer," Dr. Monica Morrow of Northwestern University, Chicago, wrote in an editorial accompanying the studies (N. Engl. J. Med. 347[16]:1270-71, 2002).

One of the studies followed 701 women who had tumors that were no bigger than 2 cm in diameter and were randomized to treatment with a radical mastectomy or a quadrantectomy followed by radiotherapy to the ipsilateral mammary tissue. Adjuvant chemotherapy was also used later in the study for women in either group who had positive axillary lymph nodes, reported Dr. Umberto Veronesi of the European Institute of Oncology in Milan and his associates (N. Engl. J. Med. 347[16]:1227-32, 2002).

The death rates from breast cancer after a median 20-year follow-up were 26% among those who underwent breast-conserving surgery and postoperative ...