Lumpectomy Compared with Lumpectomy and Radiation Therapy for the Treatment of Intraductal Breast Cancer

Bernard Fisher, Joseph P. Costantino, Carol Redmond, Edwin R. Fisher, Richard G. Margolese, Nikolay Dimitrov, Norman Wolmark, D. Lawrence Wickerham, Melvin Deutsch, Liora Ore,

New England Journal of Medicine · 1993 · 831 citations · 19 references

Concepts

TL;DR

Women with ductal carcinoma in situ are treated with lumpectomy alone or with added radiation, but the advantage of combined therapy remains unclear. In a randomized trial of 818 women, patients received either lumpectomy alone or lumpectomy plus 50‑Gy breast irradiation, with clear surgical margins and a mean 43‑month follow‑up to assess event‑free survival.

Abstract

Women with ductal carcinoma in situ have been treated both by lumpectomy and by lumpectomy followed by radiation therapy, but the benefit of combined therapy is uncertain. A group of 818 women with ductal carcinoma in situ were randomly assigned to undergo lumpectomy or lumpectomy followed by breast irradiation (50 Gy). Sufficient tissue was removed that the margins of the resected specimens were histologically tumor-free. The mean duration of follow-up was 43 months (range, 11 to 86). The principal end point of the study was event-free survival, as defined by the presence of no new ipsilateral or contralateral breast cancers, regional or distant metastases, or other cancers and by no deaths from causes other than cancer.

References

19