Breast cancer. Experiences with conservation therapy.

A series of 1,504 patients with clinically node-negative carcinoma of the breast treated by breast conservation has been followed for 26 years. The majority did not have an axillary dissection. A relative survival of 84% at 5 years and 72% at 10 years compares favorably with reported survival rates for radical surgery. Postoperative irradiation does not influence survival but breast irradiation reduces relapse in the breast. Irradiation of the regional nodes is unnecessary. Lumpectomy alone in clinically node-negative patients produces a survival rate equivalent to more radical treatment. Younger patients had larger tumors, an increased risk of breast relapse, and reduced survival. Local or distant relapse was not a function of estrogen receptor (ER) or progesterone receptor (PR) status.