BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6985.1018 (Published 15 April 1995) Cite this as: BMJ 1995;310:1018

Two long term follow ups of breast cancer trials appeared last week. Bonnadona and colleagues began their trial of adjuvant chemotherapy in 1973. A total of 386 women treated by radical mastectomy and with positive axillary nodes were given 12 months' chemotherapy or no further treatment. Twenty years on (New England Journal of Medicine 1995;332:901-6) 34% of the women given chemotherapy and 25% of those treated only surgically were still alive. Almost all the deaths were due to recurrent breast cancer. No benefit from chemotherapy was seen in women over the age of 60.

The other paper on a breast cancer trial, also in the “New England Journal of Medicine” (1995;332:907-11), gives the results of a trial of modified radical mastectomy against the combination of lumpectomy, axillary dissection, and radiotherapy conducted by the National Cancer Institute in 237 women. After 10 years' survival was 75% for the patients assigned to mastectomy and 77% for those assigned to lumpectomy. The actuarial rate of recurrence in the ipsilateral breast was 18%—but after salvage mastectomy 12 of the 19 patients with such recurrences …

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