FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 347:1227-1232 October 17, 2002 Number 16 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Morrow, M. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background We conducted 20 years of follow-up of women enrolled in a randomized trial to compare the efficacy of radical (Halsted) mastectomy with that of breast-conserving surgery.

Methods From 1973 to 1980, 701 women with breast cancers measuring no more than 2 cm in diameter were randomly assigned to undergo radical mastectomy (349 patients) or breast-conserving surgery (quadrantectomy) followed by radiotherapy to the ipsilateral mammary tissue (352 patients). After 1976, patients in both groups who had positive axillary nodes also received adjuvant chemotherapy with cyclophosphamide, methotrexate, and fluorouracil.

Results Thirty women in the group that underwent breast-conserving therapy had a recurrence of tumor in the same breast, whereas eight women in the radical-mastectomy group had local recurrences (P<0.001). The crude cumulative incidence of these events was 8.8 percent and 2.3 percent, respectively, after 20 years. In contrast, there was no significant difference between the two groups in the rates of contralateral-breast carcinomas, distant metastases, or second primary cancers. After a median follow-up of 20 years, the rate of death from all causes was 41.7 percent in the group that underwent breast-conserving surgery and 41.2 percent in the radical-mastectomy group (P=1.0). The respective rates of death from breast cancer were 26.1 percent and 24.3 percent (P=0.8).

Conclusions The long-term survival rate among women who undergo breast-conserving surgery is the same as that among women who undergo radical mastectomy. Breast-conserving surgery is therefore the treatment of choice for women with relatively small breast cancers.

Source Information

From the Department of Senology, European Institute of Oncology (U.V., A.L., M.A.); the Departments of Senology (N.C., M.G., R.S.) and Biometrics (L.M.), Istituto Nazionale per lo Studio e la Cura dei Tumori; and the Institute of Medical Statistics and Biometry, Università degli Studi (E.M.) — all in Milan, Italy.

Address reprint requests to Dr. Veronesi at the European Institute of Oncology, 435 Via G. Ripamonti, I-20141 Milan, Italy, or at umberto.veronesi{at}ieo.it.

Full Text of this Article

This article has been cited by other articles:

• Mohiuddin, M. M., Regine, W. F. (2009). Consenting the Patient With Early-Stage Breast Cancer: "Informed" Only After Multi-Discliplinary Evaluation. JCO 27: e158-e159 [Full Text]  
• Collins, E. D., Moore, C. P., Clay, K. F., Kearing, S. A., O'Connor, A. M., Llewellyn-Thomas, H., Barth, R. J. Jr, Sepucha, K. (2009). Reply to M.M. Mohiuddin et al. JCO 27: e162-e163 [Full Text]  
• Throckmorton, A., Esserman, L. (2009). Reply to M.M. Mohiuddin et al. JCO 27: e160-e161 [Full Text]  
• Jones, H. A., Antonini, N., Hart, A. A.M., Peterse, J. L., Horiot, J.-C., Collin, F., Poortmans, P. M., Oei, S. B., Collette, L., Struikmans, H., Van den Bogaert, W. F., Fourquet, A., Jager, J. J., Schinagl, D. A.X., Warlam-Rodenhuis, C. C., Bartelink, H. (2009). Impact of Pathological Characteristics on Local Relapse After Breast-Conserving Therapy: A Subgroup Analysis of the EORTC Boost Versus No Boost Trial. JCO 27: 4939-4947 [Abstract] [Full Text]  
• MacDonald, S., Taghian, A. G. (2009). Prognostic Factors for Local Control After Breast Conservation: Does Margin Status Still Matter?. JCO 27: 4929-4930 [Full Text]  
• Botteri, E., Bagnardi, V., Rotmensz, N., Gentilini, O., Disalvatore, D., Bazolli, B., Luini, A., Veronesi, U. (2009). Analysis of local and regional recurrences in breast cancer after conservative surgery. Ann Oncol 0: mdp386v1-mdp386 [Abstract] [Full Text]  
• Hawley, S. T., Griggs, J. J., Hamilton, A. S., Graff, J. J., Janz, N. K., Morrow, M., Jagsi, R., Salem, B., Katz, S. J. (2009). Decision Involvement and Receipt of Mastectomy Among Racially and Ethnically Diverse Breast Cancer Patients. JNCI J Natl Cancer Inst 101: 1337-1347 [Abstract] [Full Text]  
• Hansen, N. M., Grube, B., Ye, X., Turner, R. R., Brenner, R. J., Sim, M.-S., Giuliano, A. E. (2009). Impact of Micrometastases in the Sentinel Node of Patients With Invasive Breast Cancer. JCO 27: 4679-4684 [Abstract] [Full Text]  
• Katipamula, R., Degnim, A. C., Hoskin, T., Boughey, J. C., Loprinzi, C., Grant, C. S., Brandt, K. R., Pruthi, S., Chute, C. G., Olson, J. E., Couch, F. J., Ingle, J. N., Goetz, M. P. (2009). Trends in Mastectomy Rates at the Mayo Clinic Rochester: Effect of Surgical Year and Preoperative Magnetic Resonance Imaging. JCO 27: 4082-4088 [Abstract] [Full Text]  
• Houssami, N., Hayes, D. F. (2009). Review of Preoperative Magnetic Resonance Imaging (MRI) in Breast Cancer: Should MRI Be Performed on All Women with Newly Diagnosed, Early Stage Breast Cancer?. CA Cancer J Clin 59: 290-302 [Abstract] [Full Text]  
• Schaefer, G. O., Emanuel, E. J., Wertheimer, A. (2009). The Obligation to Participate in Biomedical Research. JAMA 302: 67-72 [Abstract] [Full Text]  
• Kreike, B., Halfwerk, H., Armstrong, N., Bult, P., Foekens, J. A., Veltkamp, S. C., Nuyten, D. S.A., Bartelink, H., van de Vijver, M. J. (2009). Local Recurrence after Breast-Conserving Therapy in Relation to Gene Expression Patterns in a Large Series of Patients. Clin. Cancer Res. 15: 4181-4190 [Abstract] [Full Text]  
• Botteri, E., Rotmensz, N., Sangalli, C., Toesca, A., Peradze, N., De Oliveira Filho, H. R., Sagona, A., Intra, M., Veronesi, P., Galimberti, V., Luini, A., Veronesi, U., Gentilini, O. (2009). Unavoidable mastectomy for ipsilateral breast tumour recurrence after conservative surgery: patient outcome. Ann Oncol 20: 1008-1012 [Abstract] [Full Text]  
• Collins, E. D., Moore, C. P., Clay, K. F., Kearing, S. A., O'Connor, A. M., Llewellyn-Thomas, H. A., Barth, R. J. Jr, Sepucha, K. R. (2009). Can Women With Early-Stage Breast Cancer Make an Informed Decision for Mastectomy?. JCO 27: 519-525 [Abstract] [Full Text]  
• Buchholz, T. A. (2009). Radiation Therapy for Early-Stage Breast Cancer after Breast-Conserving Surgery. NEJM 360: 63-70 [Full Text]  
• Solin, L. J. (2009). The Effect of Breast Magnetic Resonance Imaging on Long-term Outcome after Breast Conservation Treatment with Radiation. Am Soc Clin Oncol Ed Book 2009: 51-54 [Abstract] [Full Text]  
• Kim, S. J., Ko, E. Y., Shin, J. H., Kang, S. S., Mun, S. H., Han, B.-K., Cho, E. Y. (2008). Application of Sonographic BI-RADS to Synchronous Breast Nodules Detected in Patients with Breast Cancer. Am. J. Roentgenol. 191: 653-658 [Abstract] [Full Text]  
• Godinez, J., Gombos, E. C., Chikarmane, S. A., Griffin, G. K., Birdwell, R. L. (2008). Breast MRI in the Evaluation of Eligibility for Accelerated Partial Breast Irradiation. Am. J. Roentgenol. 191: 272-277 [Abstract] [Full Text]  
• Yang, S. H., Yang, K. H., Li, Y. P., Zhang, Y. C., He, X. D., Song, A. L., Tian, J. H., Jiang, L., Bai, Z. G., He, L. F., Liu, Y. L., Ma, B. (2008). Breast conservation therapy for stage I or stage II breast cancer: a meta-analysis of randomized controlled trials. Ann Oncol 19: 1039-1044 [Abstract] [Full Text]  
• Haffty, B. G., Buchholz, T. A., McCormick, B. (2008). Should Intensity-Modulated Radiation Therapy Be the Standard of Care in the Conservatively Managed Breast Cancer Patient?. JCO 26: 2072-2074 [Full Text]  
• Ponzone, R., Sismondi, P. (2008). Patients With Breast Cancer Are Unlikely to Benefit From Prophylactic Irradiation of the Contralateral Breast. JCO 26: 1014-1015 [Full Text]  
• Solin, L. J., Orel, S. G., Hwang, W.-T., Harris, E. E., Schnall, M. D. (2008). Relationship of Breast Magnetic Resonance Imaging to Outcome After Breast-Conservation Treatment With Radiation for Women With Early-Stage Invasive Breast Carcinoma or Ductal Carcinoma in Situ. JCO 26: 386-391 [Abstract] [Full Text]  
• Rakovitch, E., Pignol, J.-P., Hanna, W., Narod, S., Spayne, J., Nofech-Mozes, S., Chartier, C., Paszat, L. (2007). Significance of Multifocality in Ductal Carcinoma In Situ: Outcomes of Women Treated With Breast-Conserving Therapy. JCO 25: 5591-5596 [Abstract] [Full Text]  
• Brenner, D. J., Shuryak, I., Russo, S., Sachs, R. K. (2007). Reducing Second Breast Cancers: A Potential Role for Prophylactic Mammary Irradiation. JCO 25: 4868-4872 [Full Text]  
• Paganelli, G., Ferrari, M., Ravasi, L., Cremonesi, M., De Cicco, C., Galimberti, V., Sivolapenko, G., Luini, A., De Santis, R., Travaini, L. L., Fiorenza, M., Chinol, M., Papi, S., Zanna, C., Carminati, P., Veronesi, U. (2007). Intraoperative Avidination for Radionuclide Therapy: A Prospective New Development to Accelerate Radiotherapy in Breast Cancer. Clin. Cancer Res. 13: 5646s-5651s [Abstract] [Full Text]  
• Pruthi, S., Boughey, J. C., Brandt, K. R., Degnim, A. C., Dy, G. K., Goetz, M. P., Perez, E. A., Reynolds, C. A., Schomberg, P. J., Ingle, J. N. (2007). A Multidisciplinary Approach to the Management of Breast Cancer, Part 2: Therapeutic Considerations. Mayo Clin Proc. 82: 1131-1140 [Abstract] [Full Text]  
• Bartelink, H., Horiot, J.-C., Poortmans, P. M., Struikmans, H., Van den Bogaert, W., Fourquet, A., Jager, J. J., Hoogenraad, W. J., Oei, S. B., Warlam-Rodenhuis, C. C., Pierart, M., Collette, L. (2007). Impact of a Higher Radiation Dose on Local Control and Survival in Breast-Conserving Therapy of Early Breast Cancer: 10-Year Results of the Randomized Boost Versus No Boost EORTC 22881-10882 Trial. JCO 25: 3259-3265 [Abstract] [Full Text]  
• Bilimoria, K. Y., Cambic, A., Hansen, N. M., Bethke, K. P. (2007). Evaluating the Impact of Preoperative Breast Magnetic Resonance Imaging on the Surgical Management of Newly Diagnosed Breast Cancers. Arch Surg 142: 441-447 [Abstract] [Full Text]  
• Katz, S. J., Hawley, S. T. (2007). From Policy To Patients And Back: Surgical Treatment Decision Making For Patients With Breast Cancer. Health Aff (Millwood) 26: 761-769 [Abstract] [Full Text]  
• Lehman, C. D., Gatsonis, C., Kuhl, C. K., Hendrick, R. E., Pisano, E. D., Hanna, L., Peacock, S., Smazal, S. F., Maki, D. D., Julian, T. B., DePeri, E. R., Bluemke, D. A., Schnall, M. D., the ACRIN Trial 6667 Investigators Group, (2007). MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer. NEJM 356: 1295-1303 [Abstract] [Full Text]  
• Waljee, J. F., Rogers, M. A.M., Alderman, A. K. (2007). Decision Aids and Breast Cancer: Do They Influence Choice for Surgery and Knowledge of Treatment Options?. JCO 25: 1067-1073 [Abstract] [Full Text]  
• Sanders, M. E., Scroggins, T., Ampil, F. L., Li, B. D. (2007). Accelerated Partial Breast Irradiation in Early-Stage Breast Cancer. JCO 25: 996-1002 [Abstract] [Full Text]  
• Gentilini, O, Botteri, E, Rotmensz, N, Santillo, B, Peradze, N, Saihum, R., Intra, M, Luini, A, Galimberti, V, Goldhirsch, A, Veronesi, U (2007). When can a second conservative approach be considered for ipsilateral breast tumour recurrence?. Ann Oncol 18: 468-472 [Abstract] [Full Text]  
• Toledano, A., Azria, D., Garaud, P., Fourquet, A., Serin, D., Bosset, J.-F., Miny-Buffet, J., Favre, A., Le Floch, O., Calais, G. (2007). Phase III Trial of Concurrent or Sequential Adjuvant Chemoradiotherapy After Conservative Surgery for Early-Stage Breast Cancer: Final Results of the ARCOSEIN Trial. JCO 25: 405-410 [Abstract] [Full Text]  
• Vlastos, G., Verkooijen, H. M. (2007). Minimally Invasive Approaches for Diagnosis and Treatment of Early-Stage Breast Cancer. The Oncologist 12: 1-10 [Abstract] [Full Text]  
• McCarthy, E. P., Ngo, L. H., Roetzheim, R. G., Chirikos, T. N., Li, D., Drews, R. E., Iezzoni, L. I. (2006). Disparities in breast cancer treatment and survival for women with disabilities.. ANN INTERN MED 145: 637-645 [Abstract] [Full Text]  
• Kimmick, G., Camacho, F., Foley, K. L., Levine, E. A., Balkrishnan, R., Anderson, R. (2006). Racial Differences in Patterns of Care Among Medicaid-Enrolled Patients With Breast Cancer. J Oncol Pract 2: 205-213 [Abstract] [Full Text]  
• Harris, E. E.R., Correa, C., Hwang, W.-T., Liao, J., Litt, H. I., Ferrari, V. A., Solin, L. J. (2006). Late Cardiac Mortality and Morbidity in Early-Stage Breast Cancer Patients After Breast-Conservation Treatment. JCO 24: 4100-4106 [Abstract] [Full Text]  
• Pierce, L. J., Levin, A. M., Rebbeck, T. R., Ben-David, M. A., Friedman, E., Solin, L. J., Harris, E. E., Gaffney, D. K., Haffty, B. G., Dawson, L. A., Narod, S. A., Olivotto, I. A., Eisen, A., Whelan, T. J., Olopade, O. I., Isaacs, C., Merajver, S. D., Wong, J. S., Garber, J. E., Weber, B. L. (2006). Ten-Year Multi-Institutional Results of Breast-Conserving Surgery and Radiotherapy in BRCA1/2-Associated Stage I/II Breast Cancer. JCO 24: 2437-2443 [Abstract] [Full Text]  
• Bogart, J. A., Seagren, S. L., Glicksman, A. (2006). Radiation oncology research in the cancer and leukemia group B.. Clin. Cancer Res. 12: 3628s-3634s [Abstract] [Full Text]  
• Wapnir, I. L., Anderson, S. J., Mamounas, E. P., Geyer, C. E. Jr, Jeong, J.-H., Tan-Chiu, E., Fisher, B., Wolmark, N. (2006). Prognosis After Ipsilateral Breast Tumor Recurrence and Locoregional Recurrences in Five National Surgical Adjuvant Breast and Bowel Project Node-Positive Adjuvant Breast Cancer Trials. JCO 24: 2028-2037 [Abstract] [Full Text]  
• Son, B. H., Kwak, B. S., Kim, J. K., Kim, H. J., Hong, S. J., Lee, J. S., Hwang, U. K., Yoon, H. S., Ahn, S. H. (2006). Changing patterns in the clinical characteristics of korean patients with breast cancer during the last 15 years.. Arch Surg 141: 155-160 [Abstract] [Full Text]  
• Intra, M., Leonardi, C., Luini, A., Veronesi, P., Gennari, R., Gatti, G., Ciocca, M., Soteldo, J., Bassi, F., Venturino, M., Orecchia, R., Veronesi, U. (2005). Full-Dose Intraoperative Radiotherapy With Electrons in Breast Surgery: Broadening the Indications. Arch Surg 140: 936-939 [Abstract] [Full Text]  
• Ryan, P. D., Kopans, D. B., Sgroi, D. C. (2005). Case 24-2005 - A 58-Year-Old Woman with Early-Stage Estrogen-Receptor-Positive Breast Cancer. NEJM 353: 617-622 [Full Text]  
• DiFronzo, L. A., Tsai, P. I., Hwang, J. M., Lee, J. J., Ryoo, M. C., Rahimian, J., Tome, M., Takasugi, J. K., Haigh, P. I. (2005). Breast Conserving Surgery and Accelerated Partial Breast Irradiation Using the MammoSite System: Initial Clinical Experience. Arch Surg 140: 787-794 [Abstract] [Full Text]  
• Mamounas, E. P. (2005). Continuing Evolution in Breast Cancer Surgical Management. JCO 23: 1603-1606 [Full Text]  
• Newman, L. A., Kuerer, H. M. (2005). Advances in Breast Conservation Therapy. JCO 23: 1685-1697 [Full Text]  
• Arthur, D. W., Vicini, F. A. (2005). Accelerated Partial Breast Irradiation As a Part of Breast Conservation Therapy. JCO 23: 1726-1735 [Full Text]  
• Wiener, J. I., Schilling, K. J., Adami, C., Obuchowski, N. A. (2005). Assessment of Suspected Breast Cancer by MRI: A Prospective Clinical Trial Using a Combined Kinetic and Morphologic Analysis. Am. J. Roentgenol. 184: 878-886 [Abstract] [Full Text]  
• Mauri, D., Pavlidis, N., Ioannidis, J. P. A. (2005). Neoadjuvant Versus Adjuvant Systemic Treatment in Breast Cancer: A Meta-Analysis. JNCI J Natl Cancer Inst 97: 188-194 [Abstract] [Full Text]  
• Luini, A., Gatti, G., Ballardini, B., Zurrida, S., Galimberti, V., Veronesi, P., Vento, A. R., Monti, S., Viale, G., Paganelli, G., Veronesi, U. (2005). Development of axillary surgery in breast cancer. Ann Oncol 16: 259-262 [Abstract] [Full Text]  
• Roubidoux, M. A., Sabel, M. S., Bailey, J. E., Kleer, C. G., Klein, K. A., Helvie, M. A. (2004). Small (<2.0-cm) Breast Cancers: Mammographic and US Findings at US-guided Cryoablation--Initial Experience. Radiology 233: 857-867 [Abstract] [Full Text]  
• Goffin, J. R., Savage, C., Tu, D., Shepherd, L., Whelan, T. J., Olivotto, I. A. (2004). The difference between study recommendations, stated policy, and actual practice in a clinical trial. Ann Oncol 15: 1267-1273 [Abstract] [Full Text]  
• Vargas, H. I., Khalkhali, I., Gonzalez, K. D., Eldrageely, K., Burla, M., Vargas, M. P. (2004). Use of Preoperative Breast Ultrasonography for Mapping of Breast Cancer Extent Improves Resection Margins During Breast Conservation Surgery. Arch Surg 139: 863-869 [Abstract] [Full Text]  
• Whelan, T., Levine, M., Willan, A., Gafni, A., Sanders, K., Mirsky, D., Chambers, S., O'Brien, M. A., Reid, S., Dubois, S. (2004). Effect of a Decision Aid on Knowledge and Treatment Decision Making for Breast Cancer Surgery: A Randomized Trial. JAMA 292: 435-441 [Abstract] [Full Text]  
• Dowlatshahi, K., Snider, H. C., Gittleman, M. A., Nguyen, C., Vigneri, P. M., Franklin, R. L. (2004). Early Experience With Balloon Brachytherapy for Breast Cancer. Arch Surg 139: 603-608 [Abstract] [Full Text]  
• Hansen, N. M., Ye, X., Grube, B. J., Giuliano, A. E. (2004). Manipulation of the Primary Breast Tumor and the Incidence of Sentinel Node Metastases From Invasive Breast Cancer. Arch Surg 139: 634-640 [Abstract] [Full Text]  
• Joseph, K.-A., El-Tamer, M., Komenaka, I., Troxel, A., Ditkoff, B. A., Schnabel, F. (2004). Predictors of Nonsentinel Node Metastasis in Patients With Breast Cancer After Sentinel Node Metastasis. Arch Surg 139: 648-651 [Abstract] [Full Text]  
• Swain, S. M., Wilson, J. W., Mamounas, E. P., Bryant, J., Wickerham, D. L., Fisher, B., Paik, S., Wolmark, N. (2004). Estrogen Receptor Status of Primary Breast Cancer Is Predictive of Estrogen Receptor Status of Contralateral Breast Cancer. JNCI J Natl Cancer Inst 96: 516-523 [Abstract] [Full Text]  
• Wallner, P., Arthur, D., Bartelink, H., Connolly, J., Edmundson, G., Giuliano, A., Goldstein, N., Hevezi, J., Julian, T., Kuske, R., Lichter, A., McCormick, B., Orecchia, R., Pierce, L., Powell, S., Solin, L., Vicini, F., Whelan, T., Wong, J., Coleman, C. N. (2004). Workshop on Partial Breast Irradiation: State of the Art and the Science, Bethesda, MD, December 8-10, 2002. JNCI J Natl Cancer Inst 96: 175-184 [Abstract] [Full Text]  
• Lee, J. M., Orel, S. G., Czerniecki, B. J., Solin, L. J., Schnall, M. D. (2004). MRI Before Reexcision Surgery in Patients with Breast Cancer. Am. J. Roentgenol. 182: 473-480 [Abstract] [Full Text]  
• Vinh-Hung, V., Verschraegen, C. (2004). Breast-Conserving Surgery With or Without Radiotherapy: Pooled-Analysis for Risks of Ipsilateral Breast Tumor Recurrence and Mortality. JNCI J Natl Cancer Inst 96: 115-121 [Abstract] [Full Text]  
• Krynyckyi, B. R., Kim, C. K., Goyenechea, M. R., Chan, P. T., Zhang, Z.-Y., Machac, J. (2004). Clinical Breast Lymphoscintigraphy: Optimal Techniques for Performing Studies, Image Atlas, and Analysis of Images. RadioGraphics 24: 121-145 [Abstract] [Full Text]  
• Ring, A., Webb, A., Ashley, S., Allum, W.H., Ebbs, S., Gui, G., Sacks, N.P., Walsh, G., Smith, I.E. (2003). Is Surgery Necessary After Complete Clinical Remission Following Neoadjuvant Chemotherapy for Early Breast Cancer?. JCO 21: 4540-4545 [Abstract] [Full Text]  
• Dodwell, D, Horgan, K (2003). Locoregional treatment for breast cancer. BMJ 327: 1062-1063 [Full Text]  
• Veronesi, U., Gatti, G., Luini, A., Intra, M., Ciocca, M., Sanchez, D., Zurrida, S., Navarro, S., Orecchia, R. (2003). Full-Dose Intraoperative Radiotherapy With Electrons During Breast-Conserving Surgery. Arch Surg 138: 1253-1256 [Abstract] [Full Text]  
• Mamounas, E. P. (2003). NSABP Breast Cancer Clinical Trials: Recent Results and Future Directions. Clin Med Res 1: 309-326 [Abstract] [Full Text]  
• Hirsch, A. (2003). Integrative Tumor Board: Recurrent Breast Cancer or New Primary?. Integr Cancer Ther 2: 272-276  
• Goldhirsch, A., Wood, W. C., Gelber, R. D., Coates, A. S., Thurlimann, B., Senn, H.-J. (2003). Meeting Highlights: Updated International Expert Consensus on the Primary Therapy of Early Breast Cancer. JCO 21: 3357-3365 [Abstract] [Full Text]  
• Coleman, C. N., Wallner, P. E., Abrams, J. S. (2003). Inflammatory Breast Issue. JNCI J Natl Cancer Inst 95: 1182-1183 [Full Text]  
• Vicini, F. A., Kestin, L., Chen, P., Benitez, P., Goldstein, N. S., Martinez, A. (2003). Limited-Field Radiation Therapy in the Management of Early-Stage Breast Cancer. JNCI J Natl Cancer Inst 95: 1205-1210 [Abstract] [Full Text]  
• (2003). OTHER ARTICLES NOTED (25 Oct 02 to 17 Jan 03). Evid. Based Nurs. 6: e1-7 [Full Text]  
• Sharkis, D. H., Recht, A., Sonpavde, G., Veronesi, U., Mariani, L., Fisher, B., Anderson, S., Bryant, J. (2003). Breast-Conserving Surgery for Breast Cancer. NEJM 348: 657-660 [Full Text]  
• (2003). Breast-Conserving Surgery and Radiation: Excellent Results at 20 Years. JWatch Women's Health 2003: 5-5 [Full Text]  
• Gottlieb, S. (2002). Lumpectomy is as effective as mastectomy for breast cancer. BMJ 325: 921-921 [Full Text]  
• (2002). More Long-Term Follow-Up from Breast Cancer Trials. JWatch General 2002: 2-2 [Full Text]  
• Fisher, B., Anderson, S., Bryant, J., Margolese, R. G., Deutsch, M., Fisher, E. R., Jeong, J.-H., Wolmark, N. (2002). Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer. NEJM 347: 1233-1241 [Abstract] [Full Text]  
• Morrow, M. (2002). Rational Local Therapy for Breast Cancer. NEJM 347: 1270-1271 [Full Text]