Abstract
BACKGROUND: Breast conserving surgery followed by postoperative radiotherapy, as alternative to radical mastectomy, has been accepted as an optimal method for loco- regional treatment of the majority of women with early stage of breast carcinoma. The aim of the study was to evaluate the results of postoperative radiotherapy after breast conserving surgery in the Institute for oncology and radiology of Serbia. METHODS: During the 3-year period, 109 breast cancer patients with stage I and II were treated with postoperative radiotherapy after breast conserving surgery. Ninety- four patients underwent quadrantectomy with axillary node dissection, and 15 patients underwent only tumorectomy. After surgery all patients received postoperative radiotherapy to the whole breast with tumor dose 50 Gy in 15 fractions every second day. In 52 patients radiotherapy was given to the regional lymphatics with tumor dose 45 Gy in 15 fractions every second day. Twenty-eight patients received a booster dose (10 Gy) to the tumor bed. Adjuvant systemic therapy was administered depending on the nodal involvement and steroid receptors content: 17 patients received adjuvant chemotherapy (CMF or FAC), 18 received adjuvant hormonal therapy (tamoxifen or ovarian ablation), and 6 patients received both chemo- and hormonotherapy. RESULTS: After median follow-up period of 62 months, there was no evidence of loco- regional recurrence in anyone of patients. Distant metastases occurred in 7 patients (6.4%) with median disease free interval of 27.6 months. At last follow-up 91 patients (83.4%) were alive, 4 patients (3.7%) were dead of disease, and the same number was dead of other causes. The 5-year overall survival rate was 92.9% and disease-free survival rate was 92.7%. CONCLUSION: According to our results the combined surgery and radiotherapy approach provides good local control of early breast cancer patients. Postoperative radiotherapy after breast conserving surgery with or without adjuvant systemic therapy has important role in adjuvant treatment of early breast cancer.
Highlights
Breast conserving surgery (BCS) followed by postoperative radiotherapy (RT), as alternative to total radical mastectomy, has been accepted as an optimal method for locoregional treatment of the majority of women with early stage of breast carcinoma [1]
In order to reduce the risk of local recurrences, conservative procedures require a postoperative RT, which is applied to the whole breast with a dosage varying from 50 Gy to 60 Gy with or without a booster dose on the tumor bed
The aim of the study was to evaluate the results of postoperative RT after BCS in the Institute for Oncology and Radiology of Serbia
Summary
Breast conserving surgery (BCS) followed by postoperative radiotherapy (RT), as alternative to total radical mastectomy, has been accepted as an optimal method for locoregional treatment of the majority of women with early stage of breast carcinoma [1]. Breast Cancer Trialist's Collaborative Group, in their analysis of 10-year results from 40 randomized trials, showed a reduction of about two-thirds in local recurrence after postoperative RT, irrespective of whether breast surgery involved mastectomy or conservation [8]. Breast conserving surgery followed by postoperative radiotherapy, as alternative to radical mastectomy, has been accepted as an optimal method for locoregional treatment of the majority of women with early stage of breast carcinoma.
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