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Home > Understanding Breast Cancer > Breast Cancer Research > Table 37: Mastectomy versus lumpectomy plus radiation and overall survival in early breast cancer

  


Table 37: Mastectomy versus lumpectomy plus radiation and overall survival in early breast cancer

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: For women who have the option, lumpectomy (also called breast conserving surgery) plus radiation therapy is just as effective as mastectomy for treating early breast cancer. The randomized controlled trials, pooled analyses and meta-analyses in the table below show there is no difference in overall survival between women treated with either method.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Randomized clinical trials with at least 150 participants and at least 10 years of follow-up, pooled analyses and meta-analyses.  

Study 

Study Population
(number of participants) 

Stage of
Breast Cancer
 

Follow-up
(years)
 

Overall Survival
(for length of follow-up)
 

Mastectomy 

Lumpectomy
plus Radiation
 

Randomized clinical trials 

NSABP B-06 [1]

1,851

Stage I-II

21

47%

46%NS 

EORTC [2]

868

Stage I-II

22

45%

39%NS 

Danish Breast Cancer Cooperative Group [3]

731

Stage I-III

20

58%

51%NS 

Milan [4]

701

Stage I

20

58%

59%NS 

National Cancer Institute [5]

237

Stage I-II

26

44%

38%NS 

Arriagada [6]

179

Stage I

22

52%

60%*NS 

Pooled and meta-analyses 

EBCTCG [7]

4,891

Stage I-II

10

71%

71%NS 

Jatoi et al. [8]

4,061

Stage I-II

15

NS

NS

van der Hage et al. [9]

3,648

Stage I-II/III

11

68%

72% 

 


NS = No statistically significant difference between the two groups
 

References 

1. Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, Jeong JH, Wolmark N. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 347(16):1233-41, 2002.

2.  Litière S, Werutsky G, Fentiman IS, et al. Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol. 13(4):412-9, 2012.

3. Blichert-Toft M, Nielsen M, Düring M, et al. Long-term results of breast conserving surgery vs. mastectomy for early stage invasive breast cancer: 20-year follow-up of the Danish randomized DBCG-82TM protocol. Acta Oncol. 47(4):672-81, 2008.

4. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 347(16):1227-32, 2002.

5. Simone NL, Dan T, Shih J, et al. Twenty-five year results of the national cancer institute randomized breast conservation trial. Breast Cancer Res Treat. 132(1):197-203, 2012. 

6. Arriagada R, Le MG, Guinebretiere JM, Dunant A, Rochard F, Tursz T. Late local recurrences in a randomised trial comparing conservative treatment with total mastectomy in early breast cancer patients. Ann Oncol. 14(11):1617-22, 2003.

7. Early Breast Cancer Trialists' Collaborative Group. Effects of Radiotherapy and Surgery in Early Breast Cancer. An Overview of the Randomized Trials. N Engl J Med. 333:1444-55, 1995.

8. Jatoi I, Proschan MA. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: A pooled analysis of updated results. Am J Clin Oncol. 28(3):289-94, 2005.

9. van der Hage JA, Putter H, Bonnema J, et al. on behalf of the EORTC Breast Cancer Group. Impact of locoregional treatment on the early-stage breast cancer patients: a retrospective analysis. Eur J Cancer. 39(15):2192-9, 2003. 

Updated 01/13/14