Management of early cancer of the breast. Report on an international multicentre trial supported by the Cancer Research Campaign.

In the largest controlled clinical study so far undertaken on the management of early cancer of the breast in women the results of a radical regimen (simple mastectomy and radiotherapy) were compared with those of a conservative policy (simple mastectomy alone). The study included enough patients (2268) to ensure that small but significant differences between the two treatments would emerge. With a five-year follow-up there was no evidence that routine postoperative radiotherapy was harmful or that it conferred further benefit as regards survival or distant recurrence. Radiotherapy did, however, reduce the incidence of local recurrence. Neither form of treatment can counter occult disease far from the breast that is present at the time of initial treatment, which probably accounts for the high death rate from breast cancer, but the results of the study would support the view that conservative primary treatment and subsequent adjuvant chemotherapy may be the treatment of choice in future.