Sreelesh L. S1, Alex Oommen2
The improvement in the treatment of breast cancer is due to early diagnosis, better understanding of the natural history of this disease and therapeutic improvements over the years. There is a gradual shift away from radical surgery advocated by Halsted to the breast conservative surgery during the last few decades all over the world mainly influenced by the results of several large trials of lesser surgical procedures. The aim of the study is to compare the complications, duration of surgery and hospital stay, mental satisfaction of the patients, recurrence and survival of patients undergoing breast conservative surgery and modified radical mastectomy in early breast cancer.
MATERIALS AND METHODS
This was a cohort study of patients who presented with early breast cancer to the Department of General Surgery, Medical College Hospital, Calicut, between January 2007 and December 2008. Inclusion criteria were patients with early breast cancer, clinical stage I and II. All the patients were watched for different variables and were followed up for a period of five years.
Mean hospital stay of 7.47 days was there for BCS group while MRM group stayed for 9.4 days on an average. The 5-year disease-free survival rate in BCS group was 83.33% and that of MRM group was 86.66%. The five-year Distant Disease Free Survival Rate in BCS group was 86.66%. The same was 90% in MRM group. For mental satisfaction by visual analogue scale for BCS group, the mean came as 7.9333 with std. deviation of 1.14269 and std. error of 0.20863. In MRM group, the mean was 6.8333 with std. deviation of 1.26173 and std. error of 0.23036.
The 5-year disease-free survival and 5-year Distant Disease Free Survival Rate were comparable between BCS group and MRM group. Duration of hospital stay is less for the breast conservative surgery. There is significantly better mental satisfaction for the patients who underwent conservative surgery.