Conservative breast cancer treatment: analysis of cosmetic results and the role of concomitant adjuvant chemotherapy

Abstract

Fifty-eight patients conservatively treated for T, breast cancers are analyzed for cosmetic outcome; 17 had concomitant adjuvant combination chemotherapy (cyclophosphamide, adriamycin, 5 fluorouracil). The results are evaluated by clinical criteria and a quantitative measurement by use of light field projection at 33 months median follow-up. Surgery consisted of lumpectomy and axillary dissection; radiotherapy was given to the breast only except for additional internal mammary irradiation in central and medial lesions. (50 Gy whole breast, 64 Gy electron/photon boost). Questionnaires are used for inquiry on patient experience: 88% of the patients experienced a good to excellent cosmetic outcome. According to the panel only 64% show a good to excellent cosmesis. Panel-scores on asymmetry are compared with quantitative measurements. More esophagitis and probably a higher degree of fibrosis in the boost area is found in the chemotherapy group. No differences in cosmetic outcome, complication rates, and patient experiences are seen. Results are compared with published data.