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May 17, 1958


Author Affiliations

Meriden, Conn.

JAMA. 1958;167(3):298-307. doi:10.1001/jama.1958.02990200024005

Various beliefs concerning the curability of mammary carcinoma were tested in a study of reports on 8,396 microscopically proved primary cancers of the female breast collected by a state registry over a period of 19 years. The period was broken down into two seven-year periods and one five-year period in order to discover trends in therapeutic results that might parallel changing policies in surgery, radiology, and diagnosis. Comparison of group 1 (first seven-year period, diagnosed in the years 1935 through 1941) with group 2 (1942 through 1948) revealed an increase from 46.3% to 51.0% in the number of patients surviving five years after diagnosis. This improvement of 4.7% was significant but its interpretation was not clear. There was a consistent failure of about 30% of the patients thought to have localized cancer to survive five years. The greatest improvement in survivals between groups 1 and 2 was in the type of patient that received radical surgery plus postoperative irradiation. There was also a significant difference favoring the survival of patients treated by radical surgery over those treated by limited surgery. Hence the authors would recommend the combination of radical surgery and postoperative irradiation for every patient who satisfies the criteria of suitability for treatment. In this series, the woman who had a cancer in one breast was five times as likely to develop one in the other breast as a woman who did not have one. The out-look for a younger woman in this study was no worse in terms of survival than for an older woman.