Trials of Wide Excision and Radiation Therapy at the Breast Unit, Guy’s Hospital, London

Abstract

This paper details the results of trials on breast conservation techniques that have been undertaken at Guy’s Hospital since 1960. There have been two such trials. In the first one, carried out between 1961 and 1971, 376 patients aged 50 and over with operable breast cancer were assigned by random sample to receive either wide local excision or radical mastectomy, both groups additionally receiving radiotherapy (Atkins et al. 1972). Between 1971 and 1975 a second trial was undertaken in which the same treatments were used, but in this instance only patients with clinically negative axillae were included (Hayward 1977). Patients of all ages were entered into this second series and a further 252 were randomly allocated to either wide excision or radical mastectomy. This paper will describe the results of the first series up to 20 years from the commencement of the trial, in which all patients have been followed-up for a minimum period of 11 years. The second series will be reported up to 11 years from commencement of the trial, and patients have been followed-up here for a minimum period of 7 years. The results of the two series have been reported in more detail elsewhere (Hayward 1983).