The NSABP B-06 Trial is a must know for all general surgeons and especially those with an interest in breast surgery. This multicentre trial randomised close to 2000 women with stage I or II breast cancer to mastectomy or lumpectomy, and after 20 years of follow up were able to clearly show that there was no significant difference in overall survival.

In women with early-stage breast cancer, total mastectomy does not reduce either disease free-survival or overall survival compared with breast-conserving therapy. Based on the B-06 trial, breast-conserving surgery is the preferred surgical option for most women with early-stage breast cancer.

We all learnt this at med school but were we aware of the research and evidence it was based on? As you climb the ranks of seniority it becomes increasingly important that your clinical decision making is based on sound evidence – knowing these papers and keeping abreast of the current best available evidence is paramount.

Read the full article in the New England Journal of Medicine.
Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus radiation for the treatment of invasive breast cancer. N Engl J Med. 2002 Oct 17;347(16):1233-41.