The efficacy of different combinations of radiotherapy and mastectomy after Madden was compared in 411 patients with stage II breast tumors. The least likelihood of local reccurence (4.5 +/- 1.3%) was recorded after single exposure before mastectomy and with/without adjuvant irradiation of the regional lymphatics (group I); it appeared 1.5 times as high (7.0 +/- 2.1%) after mastectomy + postoperative irradiation (group II) while the highest frequency (14.8 +/- 5.4%) was registered after surgery alone (group III). Relapse-free 10-year survival was observed in 63.5 +/- 4.7 (group I), 77.4 +/- 4.6 (group II) and 46.2 +/- % (group III), respectively, the difference between group I and II being significant. Therefore, postoperative radiotherapy in conjunction with mastectomy (Madden) should be recommended for stage II breast carcinoma when the breast cannot be salvaged.
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