the NSABP has essfully designed and conducted large-scale randomized clinical trials in colorectal and breast cancers that has altered and improved the standard of care for men and women with these diseases. More than 5,000 physicians, nurses, and other medical professionals at nearly 200 medical sites from across the United States, Canada, Puerto Rico, and Australia assist the NSABP in its mission to eliminate colorectal and breast cancers.РB-04试验Р入组1971-1985(10年随访) 病例 1665 ?腋“-”? 单纯乳房切除→待腋淋巴结阳性→腋清扫? 单纯乳房切除→腋放疗? 乳腺癌根治?腋“+”? 单纯乳房切除→腋放疗? 乳腺癌根治?结果? 腋“-”三组 DFS、DDFS、OS均无差别? 内乳LN放疗不提高生存率? 腋“+”两组 DFS、DDFS、OS均无差别? ?结论不同局部治疗并不改变I、II期乳癌生存率РB-06试验Р目的:了解保乳手术的可行性?入组1976-1995 随访12年病例 1573 ?I、II期乳癌? 保乳手术→腋清扫+放疗↘? 保乳手术→腋清扫→发现腋“+”+化疗? 单纯乳房切除→腋清扫↗?结果三组 DFS、DDFS、OS均无差别? 放疗减低了同侧复发率?结论保乳手术可行、保乳后放疗必要、腋LN+仍可保乳
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