When more than 50% of node-positive patients in both the mastectomy and BCT arms received adjuvant radiation, both arms had similar survival rates. The odds ratios comparing the two treatment regimens were not significant after grouping according to tumor size and nodal status. The pooled odds ratio comparing 10-year survival for BCT and mastectomy was 0.91. Five- and 10-year odds ratios were also determined according to adjuvant radiation protocol. Pooled survival rates and odds ratios were generated according to subgroups of nodal status and tumor size.
The most recent published results and, where available, updated patient-level data from randomized controlled trials of BCT and mastectomy for early-stage breast cancer were combined in a meta-analysis using a random effects model. To evaluate the possible variations of the relative efficacy of BCT and mastectomy in terms of overall survival according to tumor size, nodal status, and use of adjuvant radiation therapy. Meta-analysis may assist in understanding the impact of these differences on survival. The randomized trials comparing breast-conserving therapy (BCT), i.e., surgery and radiation to the breast, with mastectomy in early-stage breast cancer use a variety of protocols.
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