Section 5. Breast: Breast-conserving therapy consisting of wide excision, axillary dissection, and radiotherapy for early-stage breast cancer: the experience of the National Shikoku Cancer Center

Abstract

Four hundred and forty-eight breasts of 443 female patients were treated with breast-conserving therapy (BCT) consisting of wide excision, axillary dissection, and radiotherapy for early-stage breast cancer at the National Shikoku Cancer Center between July 1989 and December 1999. The average age at operation was 48.7 years, and the mean tumor size by palpation was 1.9 cm. Three hundred and twenty cases (71.4%) were pathologically node-negative. During a median follow-up period of 53 months, 13 patients developed local recurrence. The 5-year overall survival and local recurrence rate registered 94.5% and 3.0%, respectively. Age at operation (35 years or younger vs. 36 years or older; P = 0.0184), pathological lymph node status ( P = 0.0261), adjuvant chemotherapy ( P = 0.0198), and the combination of estrogen receptor (ER) status and adjuvant tamoxifen (TAM) (ER+ and TAM+ vs. ER– or TAM–; P = 0.0136) were statistically significantly associated with local recurrence. Histological margin status associated with local recurrence was marginally significantly ( P = 0.0751). The results of multivariate analysis revealed that age at operation, pathological lymph node status, the combination of ER status and adjuvant TAM, and histological margin status were statistically independent predictors for local recurrence. In conclusion, BCT consisting of wide excision, axillary dissection and radiotherapy is useful and effective for patients with early-stage breast cancer.