Conservative treatment of breast cancer with the QU.A.RT. technique

Data are presented from a randomized, prospective clinical trial comparing the Halsted radical mastectomy with quadrantectomy, axillary node dissection, and breast radiotherapy (QU.A.RT.). From 1973 to 1980, a total of 701 patients with tumors <2 cm and clinically negative axillary nodes were accessed; the mean time on study is 8 years. No significant differences were apparent in local/regional recurrence, relapse‐free survival, or survival. Two percent of the patients in either group developed a local recurrence, and an additional 2% demonstrated a regional treatment failure. Relapse‐free survival at 8 years was 79% in the mastectomy group and 80% in patients treated with the quadrantectomy regimen; the proportion of patients surviving was 82.5% and 85%, respectively. In histologically node‐positive patients, there appeared to be prolonged survival for women treated with quadrantectomy (82% versus 70%), although this difference was not statistically significant. It is concluded that for patients meeting the eligibility criteria of this study, there is no demonstrable disadvantage for the use of quadrantectomy, axillary node dissection, and radiotherapy to the ipsilateral breast.