Comparison of conservative surgery and radiotherapy with mastectomy in the treatment of early breast cancer.

We have compared overall survival, and local and distant recurrence-free survival in patients with early breast cancer treated by mastectomy, with patients treated by wide local excision and radiotherapy. To do this, we reviewed a consecutive, unselected series of patients presenting with early breast cancer (T0-T2, N0-N1b, UICC) between 1973 and 1981 to one surgeon (J.-C.G.) and one radiotherapist (H.T.F.). The mean follow-up was 9 years (minimum 6 years, maximum 14 years). Only 9 patients received any adjuvant therapy. At 10 years the relapse-free survival was 65% for both groups of patients; the overall 10-year survival was 70% for patients treated by wide local excision and radiotherapy, and 67% for patients treated by mastectomy. The actuarial loco-regional recurrence rate at 10 years was 15% for patients treated by wide local excision and 13% for patients treated by mastectomy. There were no significant differences in overall survival, loco-regional and distant relapse-free survival between the two groups of patients. Our results support other reports that conservative surgery and radiotherapy in early breast cancer does not adversely affect long-term prognosis.