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BMC Cancer. 2010 Jul 30;10:398. doi: 10.1186/1471-2407-10-398.

Adjuvant radiotherapy and chemotherapy in breast cancer: 30 year follow-up of survival.

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  • 1University Department of Surgery, Faculty of Medicine, University of Glasgow, Glasgow, UK, G12 8RZ.



The long term outcome (more than 15 years) of adjuvant treatment in patients with primary operable breast cancer has rarely been examined.


A randomised clinical trial of radiotherapy, chemotherapy (28 day cycles of cyclophosphamide, methotrexate and 5-fluorouracil) or both on women with primary operable breast cancer (n = 322) was followed-up for a median of 27 years.


260 (81%) patients died, 204 (78%) from breast cancer. Cancer specific survival (SE) at 10 years, 20 years and 30 years was 41 (3)%, 34 (3)% and 33 (3)% respectively. Presence of more than 3 involved lymph nodes increased cancer-specific mortality (HR 1.88, 95% CI 1.34-2.63) after adjustment for age, socio-economic deprivation and adjuvant treatment. Both age (HR 1.63, 95% CI 1.19-2.22) and involved lymph nodes (HR 1.59, 95% CI 1.17-2.14) were significant predictors of all-cause mortality after adjustment for other factors. There was no significant difference in all-cause or cancer-specific survival between patients in each of the 3 treatment arms.


The present study highlights the long term impact of node positive disease but does not indicate that any regimen was associated with significantly better long-term survival.

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