Rodger A, Montague E D, Fletcher G
Cancer. 1983 Apr 15;51(8):1388-92. doi: 10.1002/1097-0142(19830415)51:8<1388::aid-cncr2820510811>3.0.co;2-b.
Results from the standpoint of survival rates and locoregional failures are compared in three series of patients having had a radical mastectomy for breast cancer: (1) radical mastectomy alone for the patients who had essentially outer quadrant lesions and a negative axilla; (2) postoperative irradiation when the axillary nodes were positive and/or the tumor was centrally located or in the inner quadrants; and (3) preoperative irradiation for patients with an outside biopsy presenting with a very disturbed breast with edema and ecchymosis, and in a small group of patients with a lesion of clinically borderline operability. The ten-year survival rates are identical in the three groups. In the radical mastectomy alone group, 14% of the patients had positive axillary nodes, in the preoperative irradiation group 30% (probably one half of the true incidence without preoperative irradiation), and in the postoperative group, 71%. This data is indicative that irradiation, either pre- or postoperatively, has survival benefits since there is direct relationship between the percentage of patients with positive axillary nodes and the survival rates. However, there is no evidence that preoperative irradiation is superior to postoperative irradiation.
对三组接受乳腺癌根治性乳房切除术的患者，从生存率和局部区域复发情况的角度比较结果：（1）对于主要为外象限病变且腋窝淋巴结阴性的患者，仅行根治性乳房切除术；（2）腋窝淋巴结阳性和/或肿瘤位于中央或内象限的患者，术后进行放疗；（3）对于活检显示乳房严重紊乱伴水肿和瘀斑的外侧病变患者，以及一小部分临床可手术性处于临界状态的病变患者，进行术前放疗。三组的十年生存率相同。在仅行根治性乳房切除术的组中，14%的患者腋窝淋巴结阳性；在术前放疗组中为30%（可能是未进行术前放疗时实际发生率的一半）；在术后放疗组中为71%。这些数据表明，术前或术后放疗均有生存获益，因为腋窝淋巴结阳性患者的百分比与生存率之间存在直接关系。然而，没有证据表明术前放疗优于术后放疗。
