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Do surgical oncologists achieve lower rates of local‐regional recurrence in node positive breast cancer treated with mastectomy alone?

Adjuvant radiotherapy for node positive breast cancer postmastectomy has been recommended by two previously published randomized controlled trials (RCT). The local‐regional recurrence rates in the control arms, however, were considered by some critics to be excessive (> 25% at 10 years). Inadequate surgery, as evidenced by the low number of axillary nodes reported, may have resulted in the high local‐regional recurrence rates, allowing for the benefits seen with radiotherapy. Fellowship trained surgical oncologists might provide “better quality” surgery, resulting in lower recurrence rates and thus making adjuvant radiotherapy unnecessary. Our objective was to establish the local‐regional control rate postmastectomy in node positive breast cancer patients operated on by surgical oncologists, and to determine if treatment recommendations from previous RCTs are generalizable.