Goodson W H
Drugs Exp Clin Res. 1986;12(1-3):153-8.
Most studies of the treatment of early breast cancer with conservative surgery and radiation therapy have had two major shortcomings: they have been based largely on short-term follow-up; and they have compared their short-term results only with long-term results after mastectomy. These methods greatly underestimate the actual incidence of local recurrence after breast preservation combined with radiation therapy because a significant portion (50% or more) of local recurrences after radiation treatment for early breast cancer are recognized more than five years after treatment. The effect of radiation is more accurately assessed by comparing results with conservative surgery without radiation therapy. This allows an estimate of the effect of the radiation therapy itself. Ten-year local recurrence rates after treatment of early breast cancer with mastectomy, conservative surgery with radiation therapy and conservative surgery without radiation therapy are 0-8%, 13-26% and 16-19% respectively. When breast preservation is combined with radiation therapy there is a lower incidence of local recurrence at five years, but at 10 years the results with and without radiation therapy are quite comparable. In both situations the recurrence rates are much higher than after mastectomy. The significance of this higher recurrence rate has not been fully evaluated. All reports of the treatment of early breast cancer should have at least 10 years of follow-up. Under no circumstances should any data be published which include patients followed for less than five years.
它们很大程度上基于短期随访；并且仅将其短期结果与乳房切除术后的长期结果进行比较。这些方法极大地低估了保乳联合放射治疗后局部复发的实际发生率，因为早期乳腺癌放射治疗后相当一部分（50%或更多）的局部复发是在治疗五年后才被发现的。通过将结果与未进行放射治疗的保乳手术进行比较，可以更准确地评估放射治疗的效果。这有助于估计放射治疗本身的效果。早期乳腺癌采用乳房切除术、保乳手术联合放射治疗以及保乳手术未联合放射治疗后的十年局部复发率分别为0 - 8%、13 - 26%和16 - 19%。当保乳联合放射治疗时，五年时局部复发率较低，但十年时，有放射治疗和无放射治疗的结果相当。在这两种情况下，复发率都远高于乳房切除术后。这种较高复发率的意义尚未得到充分评估。所有关于早期乳腺癌治疗的报告都应至少有十年的随访。在任何情况下，都不应公布随访时间少于五年的患者数据。
