Abstract: Objective To review the efficacy of breast conservative surgery(BCS),compared with modified radical mastectomy(MRM)for elderly patients with breast cancer.MethodsLiteratures related to clinical trials of comparing BCS and MRM on elderly patients with breast cancer were searched from Cochrane Library(Issue 1,2009),MEDLINE(PubMed 1965～2009.5.2),Embase(1974～2009.5.2),CBM-disc(1978～2009.5.2)and CNKI(1979～2009.5.2).The qualities of the literatures were assessed before data collection,and the statistic analysis was conducted by using RevMan 5.0.ResultsTwo studies were enrolled which included a randomized controlled trial(RCT)and a quasi-RCT,and involved totally 343 patients.No significant differences were found between BCS and MRM in terms of survival rate,mortality,local relapse rate and distant metastasis rate at 5-year.While at 10-year,the BCS group was with significantly lower mortality and distant metastasis rate,but two groups were with similar survival rate,local relapse rate and disease free survival rate.ConclusionsWhen elderly patients with solitary breast cancer staged at T1,T2 or T3a and N0,N1a,N1b or M0 are able to tolerate both BCS and MRM,BCS should be a superior option.Since the comparison study on BCS and MRM is limited currently,it is necessary to develop and design more high quality randomized controlled trials.

Key words: Breast conservative surgery, Modified radical mastectomy, Elderly, Breast cancer, Systematic review