Breast carcinoma and surgical treatment. Results from randomized studies.

Few randomized studies including a sufficient number of patients comparing different methods of loco-regional treatment have been performed on operable breast carcinoma. This review summarizes the findings after total mastectomy with or without lymph-node dissection and/or radiotherapy. There was no difference in survival or local recurrence rates between extended radical mastectomy and radical mastectomy or mastectomy plus loco-regional radiotherapy. The results after radical mastectomy with or without loco-regional radiotherapy are the same as after modified radical mastectomy. Simple mastectomy plus loco-regional radiotherapy offers the same prospects of survival as modified or radical mastectomy with or without loco-regional radiotherapy. In some studies loco-regional radiotherapy after various forms of total mastectomy reduced loco-regional recurrences, but did not affect overall survival. Preoperative radiotherapy seems to enhance survival prospects after modified radical mastectomy, but only time will tell if this effect will be sustained.