A Comparison of the Results in a Series of Cases of Carcinoma of the Breast Treated by Postoperative Roentgen Therapy for Prophylaxis with a Similar Series in which Operation was the Only Treatment

Abstract

The medical literature of the past twenty years contains many reports of the results of radical operations for the treatment of carcinoma of the breast. These reports show variations of from 15 to 50 per cent in the number of patients surviving for five years following treatment. The mean average five-year survival rate computed from the reports of many surgeons is 28.0 per cent (Table I).

This wide variation in the results obtained by different individuals or groups probably cannot be explained entirely on the basis of differences in the skill of the eminent surgeons reporting, since the technic of radical operations has become fairly well standardized in the past thirty years, and every patient presents the same anatomical limitations in the amount of tissue which may be removed with impunity. The variations in results must be attributable to differences in the types of carcinoma treated. Those who report relatively low percentages of five-year survivals have operated upon a greater number of patients in the more advanced stages of the disease, whereas those who report relatively high survival rates have chosen not to operate upon such patients.

The literature contains, also, reports of results based upon large series of cases in which operation was performed by several individuals, and comparisons between series in which surgery was the only treatment and others in which roentgen therapy was employed after operation. From these reports, many individuals have concluded, and retain the opinion, that roentgen therapy following operation does not increase the period of survival. In fact, some reports seem to indicate that the period of survival of irradiated patients is less than that of the non-irradiated, and, therefore, that the treatment has actually done harm. Such conclusions are scarcely justified.