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The twenty-year report of the Milan trial: women with breast cancers of 2 cm or less who had a quadrantectomy and radiotherapy lived as long as women who had the whole breast, chest muscles and nodes removed.
From 1973 to 1980, 701 women with breast cancers measuring no more than 2 cm were randomly assigned at the Istituto Nazionale Tumori in Milan to radical (Halsted) mastectomy (349) or to quadrantectomy followed by radiotherapy to the remaining breast (352). After 1976, node-positive women in both groups also received adjuvant CMF chemotherapy.
Thirty women in the breast-conserving group had a recurrence in the same breast against eight after radical mastectomy (p<0.001), a crude cumulative incidence of 8.8 against 2.3 per cent at 20 years. Contralateral cancers, distant metastases and second primaries did not differ. After a median follow-up of 20 years, death from all causes was 41.7 against 41.2 per cent (p=1.0) and death from breast cancer 26.1 against 24.3 per cent (p=0.8).
For a small breast cancer, keeping the breast does not cost survival. It is half of the evidence, with the American NSABP B-06, on which breast-conserving surgery became the standard of care.
Shares Umberto Veronesi, Fondazione IRCCS Istituto Nazionale dei Tumori, New England Journal of Medicine, Breast cancer (all types).
Shares Umberto Veronesi, Fondazione IRCCS Istituto Nazionale dei Tumori, Breast cancer (all types).
Shares Fondazione IRCCS Istituto Nazionale dei Tumori, Breast cancer (all types).
Shares Milan I (quadrantectomy against radical mastectomy), Breast cancer (all types).
Shares Umberto Veronesi, Fondazione IRCCS Istituto Nazionale dei Tumori.
Shares Milan I (quadrantectomy against radical mastectomy), Breast cancer (all types).
Shares Milan I (quadrantectomy against radical mastectomy), Breast cancer (all types).
Shares Milan I (quadrantectomy against radical mastectomy), Breast cancer (all types).
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