"Radiotherapeutic management of early breast cancer after conservative surgery "

Abstract

Breast conservation surgery combined with radiation therapy is now an accepted option for the treatment of early breast cancer. So we decided to evaluate the results of such treatment in our first group of patients treated by this method. From 1992 to 1996 , one hundred patients with Stage I and II breast cancer treated with breast conservative surgery (lumpectomy or quadrantectomy). Were irradated at Tehran Cancer Institue and Marie Curie Clinic. In stage II the whole breast and the draining lymph-node areas, and in stage I only the breast were irradiated to 50 Gray (Gy) in 5 weeks using cobat 60. a bososter dose of 10 Gy was given at the primary tumor site by photons in 1 weeks. Thirty- eight percent of patients received adjuvant chemotherapy. Tomoxifen was given to 96% . with a mean and median follow-up time of more than 3 years, three local recurrences and eight distant metastases occurred. The estimated 5 –year recurrence-free survival rate was 92% and the metastasis-free survival rate was 81%. Seventy-seven percent were disease-free with preserved breast. Young patient and those with positive margins had a higher risk for local failure. Nodal metastasis and the omission of adjuvant tamoxifen increased the distant failure rate. Complications were rare, excep for mild telangiectasia in four patients. The cosmetic result was exccllent or good in 90% of patients and the only factor with a statistically significant effect on cosmetic result was the treatment of both tangential fields per day.