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For early stage breast cancer patients, should lumpectomy + RT be recommended over mastectomy?
Randomized trials in the 1980s demonstrated equivalent survival and disease control outcomes for lumpectomy + RT vs mastectomy, but several recent population-based studies, including this report from the Netherlands, suggest an advantage to lumpectomy + RT for early stage patients. How can we reconcile level 1 evidence from an older era with population-based studies in the modern era? What is the optimal treatment to recommend for women with early stage breast cancer?
Answer from: Radiation Oncologist at Community Practice
The cancer registry based studies and long term follow-up, in my mind, reassures that even with longer follow-up, lumpectomy plus RT is equivalent to mastectomy alone without RT, and not better. That being said, a subset of early stage patients who are managed with mastectomy alone may benefit ...
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