Surgical treatment of carcinoma of the breast. V. Changes in patient population and therapeutic modalities at a metropolitan hospital (1971-1980).

This is a retrospective study of 408 patients who had mastectomy for carcinoma of the breast during 1971-1980. Over these 10 years, we have had a significant increase in Hispanic patients. Although the mean size of breast tumors among the Hispanic patients was smaller than that of our black patients, Hispanic patients are more likely to have higher numbers of positive axillary lymph nodes. Similar to the nationwide trend, over 90% of the patients had modified radical mastectomy in recent years, and adjuvant systemic chemotherapy has replaced postoperative radiotherapy for patients with axillary metastasis. Postmastectomy actuarial 5-year relapse rates of our patients with none or 1-3 positive axillary nodes were quite similar. Among patients with 1-3 positive axillary nodes, year of diagnosis and whether postoperative radiotherapy or chemotherapy was added or not did not affect disease-free probability. However, among patients who had four or more positive axillary nodes, those who were admitted after 1976 and who received systemic chemotherapy (90% had CMF) had a much lower probability of developing recurrence.