Early breast cancer: Part II. Management

Hughes, L. E.; Forbes, J. F.

doi:10.1002/bjs.1800651103

Cited by 8 publications

(4 citation statements)

References 36 publications

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“…It is known that node positive mastectomy patients have a higher incidence of loco‐regional recurrence than node negative cases 7 and that radiotherapy reduces this following a simple or radical mastectomy 16,17 . The loco‐regional recurrence rate for early cancers in this study is low (6 per cent) following mastectomy and is significantly less than local excision and radiotherapy at five years.…”

Section: Discussionmentioning

confidence: 52%

“…There are several retrospective studies of a variety of radiotherapeutic regimes following local excision or partial mastectomy that demonstrate survival figures equal to those following radical surgery, 10–13 and this study provides further evidence. However, others consider that the case against radical mastectomy is still not proven 7,14,15 …”

Section: Discussionmentioning

confidence: 99%

“…Upper and lower outer quadrant carcinomas were treated by mastectomy, with post operative radiotherapy for those with involved axillary nodes, while central and medial growths were treated by excision biopsy and post operative radiotherapy to the breast, axillary and internal mammary nodal areas. This policy was adopted because of the normal pattern of lymphatic metastases from central and medial growths — approximately 30–40 per cent of which will have involved internal mammary nodes at the time of presentation 7 . Effective radical surgery is thus impossible without using supraradical techniques.…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Local Excision and Radiotherapy with Mastectomy For Early Breast Cancer

Thompson

Jantet

1984

Int J Clinical Practice

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Comparison of Local Excision and Radiotherapy with Mastectomy For Early Breast Cancer

Thompson

Jantet

1984

Int J Clinical Practice

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“…However, the axilla is notoriously difficult to palpate for the presence of lymph nodes, and variation between trained observers in recording the presence or absence of axillary nodes may be as high as 45% (Yorkshire Breast Cancer Group, 1977, McNair andDudley, 1960). In collected series, 36% of clinically negative axillae contained positive node involvement at histology (Hughes and Forbes, 1978). Inability to detect involved nodes or lo reach agreement on the presence of palpable nodes makes clinical staging based on axillary findings quite unreliable and means that the planning of treatment must be based on pathological and not clinical findings.…”

Section: Discussionmentioning

confidence: 96%

Node‐positive Breast Cancer: A Comparison of Clinical and Pathological Findings and Assessment of Axillary Clearance

Kitchen

McLennan

Mursell

1980

Australian and New Zealand Journal of Surgery

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The Breast Adjuvant Chemotherapy Study of the Anti‐Cancer Council of Victoria was set up to encourage the cooperation of clinicians from many centres who are involved in the management of early node‐positive breast cancer in Victoria. Data sheets were completed by participants, and an analysis was made of the first 100 registered patients to determine the reliability of clinical assessment related to pathological findings and to study the extent of axillary node clearance. Although all subjects were histologically node positive, 47 had no palpable axillary lymph nodes, and in only 38 were nodes considered to be clinically involved. Correlation between clinical and pathological measurements of breast tumour size was significantly better (86%) with tumours over 5 cm in extent than with tumours of 5 cm or less (70%). Total mastectomy with total axillary clearance was the most common operative procedure performed. The pectoralis major was preserved in 97 and the pectoralis minor was divided or removed in 71 cases as part of the axillary clearance. In a subgroup (33) the location of involved nodes in the axilla was studied, and of these seven (21%) were found to have involved upper axillary nodes in the absence of lower axillary nodal involvement, emphasizing the inadequacy of axillary sampling in determining nodal status.

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Management and survival of female patients with “minimal” breast cancer: As observed in the long-term and short-term surveys of the american college of surgeons

Bedwani

Vána

Rosner

et al. 1981

Cancer

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The American College of Surgeons' long-term breast cancer survey in 1978 included 16,894 pathologically confirmed carcinomas of the female breast, in situ or infiltrative, with negative or positive nodes. Of these, 1.9% were in situ carcinoma of any size, and 8.4% were minimal invasive carcinomas 1 cm or less in diameter. No significant difference was found between the survival of patients with in situ tumors of any size and minimal invasive tumors with negative axillary nodes measuring 1 cm or less in diameter. In patients with invasive tumors with negative axillary lymph nodes, no statistically significant difference was found in survival of patients with tumors of 0.5 cm or less, when compared either with survival of patients with tumors measuring 0.6-1.0 cm. Recurrence rates observed in those groups were not statistically significant. Among 157 patients with invasive tumors measuring 0.5 cm or less, 23.0% presented with axillary lymph node metastasis. Tumors measuring 0.6 to 1.0 cm showed 20.9% positive axillary nodes in 964 patients. Statistically significant differences in survival and recurrence rates were achieved only for invasive tumors smaller than 1 cm. Survival and recurrence rates were significantly better (P less than 0.001) in patients with minimal invasive cancer with negative axillary nodes (P less than 0.001) than rates of patients with invasive tumors larger than 1 cm and with negative lymph nodes. Similar statistical results were obtained for patients with positive axillary nodes only for invasive cancers smaller than 1 cm. However, survival and recurrence rates observed in invasive cancers of 1 cm or less with positive axillary nodes suggest that tumor size alone cannot be used as the only defining criterion for minimal invasive breast cancer. Only the status of axillary nodes may determine whether a small invasive tumor below 1 cm may be considered as minimal breast cancer.

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Early breast cancer: Part II. Management

Cited by 8 publications

References 36 publications

A Comparison of Local Excision and Radiotherapy with Mastectomy For Early Breast Cancer

A Comparison of Local Excision and Radiotherapy with Mastectomy For Early Breast Cancer

Node‐positive Breast Cancer: A Comparison of Clinical and Pathological Findings and Assessment of Axillary Clearance

Management and survival of female patients with “minimal” breast cancer: As observed in the long-term and short-term surveys of the american college of surgeons

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