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May 15, 1967

Radiation Management of Advanced Breast Cancer

JAMA. 1967;200(7):612. doi:10.1001/jama.1967.03120200090016

Although advanced tumors of the breast may be technically resectable, radical mastectomy increases the risk of local recurrence, frequently resulting in massive carcinomatosis of the chest wall. The widespread opinion among surgeons that radical surgery offers the only chance for cure is negated by several series which have shown significant five-year survival rates and a high percentage of local control with irradiation alone,7-9 emphasizing the belief that radical mastectomy should be reserved for the primary procedure in cases with favorable clinical features.

Table 1 shows the categories of patients with breast cancer according to the clinical features of the disease.

A review of the literature shows that conventional treatment for large masses in the breast or axilla of 4,000 to 5,000 rads in four to five weeks produces only 30% local control.10 A higher control is achieved with long protracted techniques, perhaps because of better vascularization developing with