[Treatment selection for stage I breast cancer--report of 412 cases]

From 1958 to 1982, 412 Stage I breast cancer patients treated by simple operation, operation plus radiotherapy and/or chemotherapy are reported. Of them, 312 were treated by radical mastectomy (R), 43 by simple mastectomy (S), 31 by modified radical mastectomy (M), 20 by tumorectomy (T) and 6 by extended radical mastectomy (E). The results showed that M and T with radiotherapy and/or chemotherapy were similar to R in terms of survival and recurrence rates. There were no differences between R, S, M, E groups and combined treatment group in recurrence rate, but there was a significant difference between T group and combined treatment group (P less than 0.01). Recurrence rate of patients with positive axillary lymph nodes was similar to that of patients with negative nodes, because 91.5% of the former patients received combined treatment, but only 54.3% of the latter patients did (P less than 0.01). Six cases in T group recurred and 4 (67%) of them were retreated by salvage surgery. Three cases survived for 15 years, giving a better result than radical mastectomy. It is indicated that modified radical mastectomy and tumorectomy plus combined treatment are advisable for Stage I breast cancer. Prospective randomized clinical trials for assessment of different treatment modalities are needed.