The Analysis Of The Clinical Result Of A Randomized Clinical Trial Comparing Breast Conservation Therapy And Modified Radical Mastectomy

Objective: By analyzing the clinical result of a random clinical trial that has been resulted from comparing Breast Conservation Therapy (BCT) with Modified Radical Mastectomy, this research is to discuss the best method applied in the treatment of early breast cancer.Methods: This study retrospectively analyzes 186 patients with early breast cancer in Anshan Tumor Hospital and An Gang Tumor Hospital from Jan. 2001 to Mar. 2005. All of these patients were female, and were diagnosed to have the single tumor with its the longest diameter less than 3cm. The tumor located in the area beyond the center and the inboard area, and the shortest distance from tumor to nipple was more than 3cm. In addition, all of these tumors were found no axillary lymph node metastasis. These patients were between 22 and 50 years old, with the average age 44.61 ±8.63. According to the method operated on them, they were divided into two groups, the group of Breast Conservation Therapy and the group of Modified Radical Mastectomy. In the group of Breast Conservation Therapy, there were 48 patients with the age between 22 to 50 and the average age of 44.45 ± 8.86, including 31 cases of I stage and 17 cases of II stage. All of them must be performed by adjuvant radiotherapy, and much more dose was performed in the base area of tumor. In the group of Modified radical mastectomy, there were 138 cases with the age between 35 and 56 and the average age of 44.87 ±9.03, including 91 cases of I stage and 47 cases of II stage. In addition, the radiotherapy scope of modified radical mastectomy was determined by both the size of the tumor and the lymph node metastasis. The patients of both two groups were performed chemotherapy, and Rx wasCMF. The patients whose ER/PR were positive were performed incretion therapy of eating tamoxifen.In the two groups, there was no obvious statistic difference (p >0.05)by analyzing all of the data, including age and stage. By comparing these two groups' local recurring rate, distant metastasis rate, and survival rate of 3 years and 5 years respectively, the research was evaluating the therapy efficiency. All of these patients were classified according to the pre-operation classification method determined by the International Anti-Tumor Association 1988.Results: In the group of breast conservation therapy, the 3year, 5year local recurring rate is2.08% 6.25%; distant metastasis rate is 0% 4.16%and survival rate is 97.93% 97.93%respectively. In the group of modified radical mastectomy, the 3year, 5year local recurring rate is 1.44% 5.07%, distant metastasis rate is 0% 5.07%,and survival rate is 98.55% 97.16% respectively. There is no obvious difference between the two groups(p> 0.05).Conclusion For patients with early stage breast cancer, combining BCT with postoperative radiotherapy can achieve the same result as the traditional modified radical mastectomy,and BCT also it has more advantages, such as less wound, lighter pain, quicker recovery, and higher quality of living etc. Therefore, the BCT should be considered as a preferable method of treating early breast cancer.