Abstract • The preponderance of evidence indicates that lumpectomy plus radiation therapy produces the same survival as modified radical mastectomy in patients with early breast cancer and further suggests that the local failure rate may be lower in the patients who undergo irradiation. In this series, patients were treated with immediate implantation of the tumor bed with iridium Ir 192. There have been two recurrences in the breast from 110 breast cancers (44% had a clinical stage greater than T1, and 41% had axillary-node involvement) in 107 patients followed up for four to 52 months (25.8±13.3 months [mean±SD]). These preliminary data suggest that local treatment failure can be minimized by aggressive, immediate intraoperative implantation of the tumor bed with iridium Ir 192. (Arch Surg 1987;122:687-690) References 1. Fisher B, Bauer M, Margolese R, et al: Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer . N Engl J Med 1985;312:665-673.Crossref 2. Veronesi U, Saccozzi R, Del Vecchio 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 3. Veronesi U, Zucali R, Luini A: Local control and survival in early breast cancer: The Milan trial . Int J Radiat Oncol Biol Phys 1986;12: 717-720.Crossref 4. Bluming A, Dosik G, Drickman M, et al: Treatment of primary breast cancer without mastectomy . Ann Surg 1986;204:136-147.Crossref 5. Romsdahl MM, Montague ED, Ames FC, et al: Conservation surgery and irradiation as treatment for early breast cancer . Arch Surg 1983;118: 521-528.Crossref 6. Mansfield CM, Jewell WR: Intraoperative interstitial implantation of iridium 192 in the breast . Radiology 1984;150:600.Crossref 7. Gump F, Shikora S, Habif D, et al: The extent and distribution of cancer in breasts with palpable primary tumors . Ann Surg 1986;204: 384-390.Crossref 8. Guttman R: Radiotherapy in the treatment of primary operable carcinoma of the breast with proved lymph node metastases: Approach and results . Am J Roentgenol 1963;89:58-63. 9. Porritt A: Early carcinoma of the breast . Br J Surg 1965;52:214-216.
Archives of Surgery – American Medical Association
Published: Jun 1, 1987