Breast cancer: a critical review of a patient sample with a ten-year follow-up.

Records of 407 patients with primary breast cancer treated at the M.D. Anderson Hospital in 1958 and 1959 were reviewed with regard to patient characteristics, treatment, and results. These patients presented with relatively advanced disease (42% were inoperable on initial evaluation). Black and Chicano patients had significantly more advanced disease on admission than did white patients. Approximately 61% of patients received treatment appropriate to their clinical category indicating that multiple factors influence therapy selection. Absolute ten-year survival free of disease was 21%. Black and Chicano patients with early disease (categories 1 and 2) had significantly worse survival than did white patients. Problems with retrospective studies are multiple and limit the validity of conclusions. Randomized controlled studies are essential to answer critical questions.