👉The NSABP B-04, A Protocol for the Evaluation of Radical Mastectomy (RM) and Total Mastectomy (TM) With and Without Radiation in the Primary Treatment of Cancer of the Female Breast.
👉It enrolled 1079 patients with clinically node-negative disease, and randomized them to RM, TM plus local-regional axillary irradiation, or TM alone.
👉In a parallel trial, 586 patients with clinically node-positive disease were randomized to RM or TM plus radiation.
👉After 25 years of follow-up, the study showed no significant difference in long-term outcome between clinically node-negative patients who received RM and those who received TM plus radiation, or between clinically node-positive patients who received RM and those who received TM with nodal irradiation.
👉When comparing the hazard ratio for death within the two arms, the results show no survival advantage from RM.
👉In patients with clinically node-negative disease, pathologic examination of the mastectomy specimen revealed that 40% of the patients had pathologically positive nodes.
👉However, because the axillary failure rate in the TM alone arm was only 19%, we are led to conclude that occult axillary disease may not always progress into clinically overt disease.
👉The similar overall survival (OS) among the three arms in this trial also indicates that an axillary dissection in this trial would be largely prophylactic, and the outcome would not be compromised should the dissection be deferred until there is clinical evidence of a diseased axilla.
My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida.
I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016.
Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida.
Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 