The fact that the overall survival of patients randomly assigned to receive breast conserving therapy and radiation in these studies is equivalent to survival of patients who underwent mastectomy in spite of the higher local failure rate suggests that recurrences confined to the irradiated breast do not have the same prognostic importance as recurrences in the lymph nodes, skin and muscle. It was tumor stage and whether the cancer had spread to the lymph nodes in the axilla. The NCI noted no difference based upon age and disease-free survival. This data should be reassuring to the many patients with cancer who believe that a diagnosis of breast cancer is a death sentence. Taken together, these numbers also demonstrate that many patients survive for a long period with local therapy only and presumably at least in part as a result of that therapy.
Adjuvant chemotherapy prolongs the survival of other patients.
We believe that improvements in survival can only arise from improvement in the early detection of breast cancer before dissemination has occurred or from improvements in adjuvant therapy. Thus, another important study confirms the effectiveness of lumpectomy and radiation. A woman can rest comfortably that there is no detriment in choosing this therapeutic modality that preserves her body more intact. Of course, the best outcome still relies on the earliest possible diagnosis.