Quadrantectomy versus lumpectomy for small size breast cancer

Area of Science:

• Oncology
• Surgical Oncology
• Radiotherapy

Background:

• Breast cancer treatment has evolved towards breast-conserving surgeries.
• Comparing surgical techniques is crucial for optimizing patient outcomes and minimizing recurrence.
• Understanding the impact of surgical margins on local recurrence rates is essential.

Purpose of the Study:

• To compare the efficacy of quadrantectomy versus lumpectomy in treating small breast carcinomas.
• To evaluate the rates of distant metastases, survival, and local recurrences between the two surgical approaches.
• To determine the optimal surgical strategy for breast-conserving therapy.

Main Methods:

• A randomized trial comparing quadrantectomy plus external radiotherapy with lumpectomy plus external and interstitial radiotherapy.
• Inclusion of total axillary dissection in both treatment arms.
• Evaluation of 705 evaluable cases (360 quadrantectomies, 345 lumpectomies).

Main Results:

• No significant differences were observed in distant metastases or overall survival between the quadrantectomy and lumpectomy groups.
• Lumpectomy resulted in a significantly higher frequency of local recurrences (7.0%) compared to quadrantectomy (2.2%).

Conclusions:

• Conservative surgical procedures for breast cancer should involve generous excision of normal tissue around the primary tumor.
• Intensive postoperative radiotherapy is a critical component in reducing local recurrence rates.
• Quadrantectomy, with its wider margins, appears superior to lumpectomy in preventing local breast cancer recurrence.