Revisão bibliográfica do tratamento conservador do câncer de mama
DOI:
https://doi.org/10.32635/2176-9745.RBC.1994v40n2.2977Keywords:
Early Breast Cancer, SurgeryAbstract
The authors describe the Milan Trials I, II and III conducted by Istituto Nazionale per lo Studio e Ia Cura del Tumori and comparativelly analyse other trials for conservative surgical approach of breast cancer through a bibliographic review on randomized clinical trials worldwide with representativo number of patients and detailed informations on follow-up. The Milan Trial I compared radical mastectomy with quadrantectomy plus complete axiliary clearance and radiotherapy (QUART) in patients clinically TiNoMo. After sixteen years similar overall survival and disease free survival were demonstrated. There was no significant statistical difference between the two groups on local reccurrence rates and second primary tumor. From 1985 to 1987, the Milan II compared QUART versus lumpectomy plus axiliary dissection plus external radiotherapy and intersticial boost with 192Ir. After four years of follow-up, curves of overall survival were virtually superimposable with better aesthetic results and worse local reccurrence rates in the second group. The last Milan trial compared QUART with quadrantectomy plus axiliary dissection without radiotherapy ending patient’s recruitmenton 1989. Its results or conclusions are notavailable. AH the clinical trials reviewed comparing radical surgery with breast conservative treatment concluded that for stage I and II breast cancer, conservative therapy plus radiotherapy is as effective as radical mastectomy or modified mastectomy.
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References
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