Role of simple mastectomy in treating patients with breast cancer

From 1945 to 1971, 473 patients had simple mastectomies as the primary treatment for their breast cancer (421 had either a simple mastectomy alone [26%], a simple mastectomy followed by postoperative radiation therapy [64%], or preoperative irradiation followed by simple mastectomy [10%]). More than one half of these patients were "inoperable" by standard surgical criteria. The local recurrence rate was 24%, which compares favorably with the reported 48% local recurrence rate for "inoperable" patients treated by radical mastectomy. These recurrences were on the chest wall in two thirds of the patients and in the regional lymph nodes of the other third. No statistical differences in survival or recurrence rate could be correlated with the site of the primary cancers in the breasts or among the three treatment groups.