NSABP B-04 — Radical Mastectomy Versus Less Extensive Surgery With or Without Radiation for Operable Breast Cancer

Phase 3 · 2002 · Breast Cancer

Design

Randomized radical mastectomy vs total (simple) mastectomy with or without radiation; node-positive patients randomized to radical mastectomy vs total mastectomy plus radiation.

Population

Operable breast cancer with clinically negative or positive nodes.

Primary Endpoint

disease-free and overall survival

Key Result

At 25 years, no significant survival difference between radical mastectomy and less extensive surgery, regardless of nodal status.

Guideline Impact

Foundational surgical-oncology evidence ending routine radical mastectomy