Conservative therapy of breast cancer. The Mayo Clinic experience

A retrospective analysis of patients with intraductal and early-stage invasive breast cancer treated with breast-conserving surgery and radiation was conducted to determine the local recurrence and survival rates. Between January 1979 and December 1989, 181 patients were treated with breast-conserving surgery and definitive radiation. Nine of these patients also had either synchronous or metachronous bilateral breast cancers also treated with breast conservation. Fourteen cases were intraductal cancer, while the remaining were invasive carcinomas. With a median length of patient follow-up of 4.9 years following initiation of radiation, the overall survival at 5 and 8 years was 93% and 83%, respectively. The local recurrence-free survival at both 5 and 8 years for all patients was 96%. The overall and recurrence-free survival of the intraductal patients alone was 100% at 5 years. Lymph node status and grade were identified as variables associated with time until recurrence based on a stepwise Cox proportional hazards model analysis. Physician assessment of cosmesis was ranked as good to excellent in 82% of patients. This study further substantiates the role of breast-conserving surgery and definitive radiation in the treatment of early-stage breast cancer.