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NSABP B-04 trial 25 years later: lessons for oncologists
- Authors: Kim A.Y.1,2, Markushin L.I.2,3, Volchenkov S.A.1,2, Osetnik V.K.1,2, Sorokin P.I.1,2, Matorina O.G.1,2, Gavrilyukova A.A.2,3, Gushchin V.V.4,5
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Affiliations:
- N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
- High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
- Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation
- High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg, Russia
- Mercy Clinic
- Issue: Vol 15, No 2 (2019)
- Pages: 52-56
- Section: MAMMOLOGY. ORIGINAL REPORTS
- Published: 06.09.2019
- URL: https://ojrs.abvpress.ru/ojrs/article/view/648
- DOI: https://doi.org/10.17650/1994-4098-2019-15-2-52-56
- ID: 648
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Abstract
This critical analysis of the article of B. Fisher et al. “Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation” (2002) was written for physicians interested in learning how evidence based oncology has challenged the Halstedian model of breast cancer progression and the radical loco-regional treatment as the way to stop this progression. The 25-year update of the NSABP B-04 study is unique in its design and the remarkable length of follow-up. Our detailed analysis of the article provides an example how oncologists learn about biology of the disease, test the hypothesis of the metastatic spread of the tumor, and what the bases of the modern principles of loco-regional treatment of breast cancer are. Also, the modern clinical recommendations are written using similar systematic analysis of the available literature. The presented analysis explains the logic behind using various end-points. This analysis illustrates how the study helps to dismantle the stereotype that super radical surgical treatment of breast cancer was effective and to promote research in less aggressive loco-regional treatments of other tumors. To our knowledge this type of analysis has never been published before in Russian oncology literature.
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About the authors
A. Ya. Kim
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
Author for correspondence.
Email: annayanovnakim@gmail.com
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationL. I. Markushin
High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg; Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation91 Volokolamskoe Shosse, Moscow 125371 Russian Federation
S. A. Volchenkov
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationV. K. Osetnik
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationP. I. Sorokin
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationO. G. Matorina
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg
68 Leningradskaya St., Pesochnyy Settlement, Saint Petersburg 197758
Russian FederationA. A. Gavrilyukova
High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg; Academy of Postgraduate Education, Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies, Federal Medical and Biological Agency of the Russian Federation91 Volokolamskoe Shosse, Moscow 125371 Russian Federation
V. V. Gushchin
High School of Oncology, Cancer Prevention Foundation “Ne naprasno”, Saint Petersburg, Russia; Mercy ClinicSt Paul Pl 345, Baltimore United States
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