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Conservative Surgery With Radiation Therapy in Clinical Stage I and II Breast Cancer: Results of a 20-Year Experience

Conservative Surgery With Radiation Therapy in Clinical Stage I and II Breast Cancer: Results of... Abstract • Conservative surgery and radiation therapy have been increasingly utilized at Yale–New Haven (Conn) Hospital since the 1960s. This analysis represents our experience from 1962 to 1982, with a total of 281 patients having a minimum assessable follow-up of five years and a median follow-up of 7.4 years. Five- and ten-year actuarial survivals were 83% and 67%, respectively. The actuarial breast recurrence-free rate was 91% at five years and 80% at ten years. Of 31 patients having recurrences in the breast alone, the actuarial five-year survival following recurrence was 48%. Twenty-eight (90%) of these 31 recurrences were salvageable with mastectomy or repeated wedge resection. Patients experiencing an early breast recurrence (less than three years) following initial treatment had a poorer prognosis than patients having recurrences later. (Arch Surg 1989;124:1266-1270) References 1. Fisher B, Bauer M, Margolese R, et al: Five-year results of randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of early breast cancer . N Engl J Med 1985;312:665-673.Crossref 2. Calle R, Vilcoq JR, Zafrani B, et al: Local control and survival of breast cancer treated by limited surgery followed by irradiation . Cancer 1986;12:873-876. 3. Delouche G, Bachelot F, Premount M, et al: Conservative treatment of early breast cancer: Long-term results and complications . Int J Radiat Oncol Biol Phys 1987;13:29-34.Crossref 4. Recht A, Silver B, Schnitt S, et al: Breast relapse following primary radiation therapy for early breast cancer: I. Classification, frequency, and salvage . Int J Radiat Oncol Biol Phys 1985;11:1271-1276.Crossref 5. Fisher B, Wolmark N: Conservative surgery: The American experience . Semin Oncol 1986;13:425-438. 6. Veronesi U, Saccozzi R, DelVecchio M, et al: Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast . N Engl J Med 1981;305:6-11.Crossref 7. Sarrazin D, Le M, Rouesse J, et al: Conservative treatment versus mastectomy in breast cancer tumors with macroscopic diameter of 20 millimeters or less: The experience of the Institut Gustave-Roussy . Cancer 1984;53:1209-1213.Crossref 8. Kurtz JM, Amalric R, DeLouche G, et al: The second ten years: Longterm risks of breast conservation , abstracted. Int J Radiat Oncol Biol Phys 1985;11( (suppl 1) ):184. 9. Schnitt S, Connolly J, Recht A, et al: Breast relapse following primary radiation therapy for early breast cancer: II. Detection, pathologic features, and prognostic significance . Int J Radiat Oncol Biol Phys 1985;11:1277-1284.Crossref 10. Clarke DH, Le MG, Sarrazin D, et al: Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: Experience of the Institut Gustave-Roussy . Int J Radiat Oncol Biol Phys 1985;11:137-145.Crossref 11. Harris JR, Recht A, Amalric R, et al: Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer . J Clin Oncol 1984;2:37-41. 12. Kurtz JM, Spitalier JM, Amalric R: Late breast recurrence after lumpectomy and irradiation . Int J Radiat Oncol Biol Phys 1983;9:1191-1194.Crossref 13. Mate TM, Carter D, Fischer D, et al: A clinical and histopathologic analysis of the results of conservative surgery and radiation therapy in stage I and II breast cancer . Cancer 1986;58:1995-2002.Crossref 14. Kurtz JM, Amalric R, Brandone KT: A second chance to preserve the breast: Results of wide excision for breast recurrence after lumpectomy and irradiation , abstracted. Int J Radiat Oncol Biol Phys 1985, (suppl 1) , p 103. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Conservative Surgery With Radiation Therapy in Clinical Stage I and II Breast Cancer: Results of a 20-Year Experience

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References (15)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1989.01410110020003
Publisher site
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Abstract

Abstract • Conservative surgery and radiation therapy have been increasingly utilized at Yale–New Haven (Conn) Hospital since the 1960s. This analysis represents our experience from 1962 to 1982, with a total of 281 patients having a minimum assessable follow-up of five years and a median follow-up of 7.4 years. Five- and ten-year actuarial survivals were 83% and 67%, respectively. The actuarial breast recurrence-free rate was 91% at five years and 80% at ten years. Of 31 patients having recurrences in the breast alone, the actuarial five-year survival following recurrence was 48%. Twenty-eight (90%) of these 31 recurrences were salvageable with mastectomy or repeated wedge resection. Patients experiencing an early breast recurrence (less than three years) following initial treatment had a poorer prognosis than patients having recurrences later. (Arch Surg 1989;124:1266-1270) References 1. Fisher B, Bauer M, Margolese R, et al: Five-year results of randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of early breast cancer . N Engl J Med 1985;312:665-673.Crossref 2. Calle R, Vilcoq JR, Zafrani B, et al: Local control and survival of breast cancer treated by limited surgery followed by irradiation . Cancer 1986;12:873-876. 3. Delouche G, Bachelot F, Premount M, et al: Conservative treatment of early breast cancer: Long-term results and complications . Int J Radiat Oncol Biol Phys 1987;13:29-34.Crossref 4. Recht A, Silver B, Schnitt S, et al: Breast relapse following primary radiation therapy for early breast cancer: I. Classification, frequency, and salvage . Int J Radiat Oncol Biol Phys 1985;11:1271-1276.Crossref 5. Fisher B, Wolmark N: Conservative surgery: The American experience . Semin Oncol 1986;13:425-438. 6. Veronesi U, Saccozzi R, DelVecchio M, et al: Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast . N Engl J Med 1981;305:6-11.Crossref 7. Sarrazin D, Le M, Rouesse J, et al: Conservative treatment versus mastectomy in breast cancer tumors with macroscopic diameter of 20 millimeters or less: The experience of the Institut Gustave-Roussy . Cancer 1984;53:1209-1213.Crossref 8. Kurtz JM, Amalric R, DeLouche G, et al: The second ten years: Longterm risks of breast conservation , abstracted. Int J Radiat Oncol Biol Phys 1985;11( (suppl 1) ):184. 9. Schnitt S, Connolly J, Recht A, et al: Breast relapse following primary radiation therapy for early breast cancer: II. Detection, pathologic features, and prognostic significance . Int J Radiat Oncol Biol Phys 1985;11:1277-1284.Crossref 10. Clarke DH, Le MG, Sarrazin D, et al: Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: Experience of the Institut Gustave-Roussy . Int J Radiat Oncol Biol Phys 1985;11:137-145.Crossref 11. Harris JR, Recht A, Amalric R, et al: Time course and prognosis of local recurrence following primary radiation therapy for early breast cancer . J Clin Oncol 1984;2:37-41. 12. Kurtz JM, Spitalier JM, Amalric R: Late breast recurrence after lumpectomy and irradiation . Int J Radiat Oncol Biol Phys 1983;9:1191-1194.Crossref 13. Mate TM, Carter D, Fischer D, et al: A clinical and histopathologic analysis of the results of conservative surgery and radiation therapy in stage I and II breast cancer . Cancer 1986;58:1995-2002.Crossref 14. Kurtz JM, Amalric R, Brandone KT: A second chance to preserve the breast: Results of wide excision for breast recurrence after lumpectomy and irradiation , abstracted. Int J Radiat Oncol Biol Phys 1985, (suppl 1) , p 103.

Journal

Archives of Surgery – American Medical Association

Published: Nov 1, 1989

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