Research table: Lumpectomy plus radiation therapy versus mastectomy for early breast cancer treatment

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: For women who have the option of a lumpectomy (also called breast-conserving surgery), a lumpectomy plus radiation therapy is as effective as a mastectomy for treating early breast cancer. 

Studies show no difference in overall survival for women with either treatment.

Learn more about lumpectomy and mastectomy.

Learn more about radiation therapy.

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 Therapy
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
Veronesi et al. [4]	701	Stage I	20	58%	59%NS
National Cancer Institute [5]	237	Stage I-II	26	44%	38%NS
Arriagada et al. [6]	179	Stage I	22	52%	60%*NS
Pooled and meta-analyses
De la Cruz Ku et al. [7]	6 randomized clinical trials	Stage I-III		NS	NS
EBCTCG [8]	4,891	Stage I-II	10	71%	71%NS
Jatoi et al. [9]	4,061	Stage I-II	15	NS	NS
van der Hage et al. [10]	3,648	Stage I-II/III	11	68%	72%

NS = No statistically significant difference between the 2 groups

* Breast cancer stage as classified before 2018

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. De la Cruz Ku G, Karamchandani M, Chambergo-Michilot D, et al. Does breast-conserving surgery with radiotherapy have a better survival than mastectomy? A meta-analysis of more than 1,500,000 patients. Ann Surg Oncol. 29(10):6163-6188, 2022.
8. 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.
9. 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.
10. 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 09/11/23