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Meta-analysis Stuart et al: 10 yr Ipsilateral Breast Recurrence
All
Subset NOT receiving
Tam
Subset also
receiving
Tamoxifen
Mastectomy
2.6%
Lumpectomy + RT 13.6% 14.1% (7.2% invasive)
9.7%
Lumpectomy - RT 25.5% 25.1% (11.3% invasive) 24%
Biopsy only
27.8%
2 adjuvant Rx significantly less invasive LR than one or none adjuvant Rx