Conservative Surgery and Radiotherapy as Primary Treatment for Early Breast Cancer: Results of a 10 Year Experience

Abstract

ABSTRACTA 10 year period of treatment at the Radiotherapy Department of the Royal Prince Alfred Hospital was analysed retrospectively in order to assess the efficacy of conservative management of early breast cancer. From May 1968 to May 1978 a total of 1,785 patients with breast cancer were treated. Of these, 30 underwent conservative surgery for Stage I or II disease, followed by a course of “radical” irradiation.Patient follow‐up ranged from 0.5 to 11.1 years (median 6.5). The 10 year actuarial probability of local tumour control for the entire group was 91% and the 5 and 10 year actuarial survivals were 82 and 53% respectively. Only three patients have died from their primary disease, and three have had local recurrences, all readily controlled with mastectomy. Sixteen patients remain alive and well, but six have died from inter‐current illness. No significant radiation complications have occurred although eight patients (28%) have developed a second primary malignancy over the ten year period.Local excision plus radiotherapy appears to be an effective alternative approach to the local treatment of primary breast cancer in selected patients. Recommendations are made concerning axillary node sampling, interstitial brachytherapy and adjuvant chemotherapy for patients treated by this technique.