E. Shelley Hwang, M.D., M.P.H., from the Duke University Medical Center in Durham, N.C., and colleagues analyzed survival data from 112,154 women who had been diagnosed with stage I or stage II breast cancer in California between 1990 and 2004 and who had received either mastectomy or breast-conserving therapy (BCT; lumpectomy plus radiation). There were 31,416 deaths as of 2009, with breast cancer as the underlying cause in 39 percent of cases.

During a median follow-up of 110.6 months, the researchers found that women who received BCT had significantly improved overall survival (adjusted hazard ratio, 0.81). BCT was also associated with significantly improved disease-specific survival, with a greater benefit for women aged 50 years or older with hormone receptor-positive disease (hazard ratio, 0.86) than among women aged younger than 50 with hormone receptor-negative disease (hazard ratio, 0.88). In all subgroups analyzed, this trend was observed.

"Among patients with early-stage breast cancer, BCT was associated with improved disease-specific survival," Hwang and colleagues conclude. "These data provide confidence that BCT remains an effective alternative to mastectomy for early-stage disease regardless of age or hormone receptor status."

Abstract
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