Roentgen Therapy in Cancer of the Breast 1 An Analysis of Experiences at the State of Wisconsin General Hospital during the Last Twelve Years Ernst A. Pohle , M.D., Ph.D. , Professor of Radiology and Roland R. Benson , M.D. , Junior Resident in Radiology University of Wisconsin Medical School, Madison, Wis. ↵ 1 From the Department of Radiology and Physical Therapy, State of Wisconsin General Hospital. Read before the Radiological Society of North America at the Twenty-seventh Annual Meeting, San Francisco, Calif., Dec. 1–5, 1941. Excerpt During the last twenty years the treatment of carcinoma of the breast has developed from a purely surgical into a surgical-radiological problem. There can be no denying the fact that a sufficient number of carefully compiled statistics have been published demonstrating the value of postoperative irradiation in cases where metastases were present at the time of operation. We freely admit that the rôle of preoperative roentgen therapy in carcinoma of the breast has not yet been definitely established and likewise that it is too early to determine the effect of routine sterilization by roentgen rays in carcinoma of the breast in women in the preclimacteric age group. In September 1940 Hidde et al. (1) published a statistical analysis of 318 patients with mammary carcinoma admitted to the State of Wisconsin General Hospital from 1924 to 1936, based on the status on July 1, 1938. They found that of 177 patients who received primary treatment at the University Hospital 30.4 per cent were still living, with observation periods ranging from three to fourteen years. These included Stages 1 to 3A, the latter referring to a patient with an ulcerated primary tumor plus metastasis in the axillary nodes; the majority (65.5 per cent) of cases were Stage 3. Since 1929 postoperative x-ray therapy has been a routine procedure and only 4 out of 125 patients seen from 1930 to 1935 were not irradiated. Although we must refer for further details to the original article, we wish to state that in conclusion the authors accept x-ray therapy as an important adjunct in the treatment of carcinoma of the breast. In advanced cases of recurrent or metastatic adenocarcinoma of the breast its palliative value is apparent while its curative value is poor. Since the study of Hidde and his associates was conducted chiefly from the surgical point of view, and because the patients treated during 1935 and 1937 have passed through a five- and three-year observation period, respectively, we considered it worth while to relate our experience, stressing particularly the radiological aspect. Technic of Treatment Preoperative Roentgen Therapy: Only a few cases were referred for preoperative irradiation and consequently no definite opinion as to its value can be offered. There are two possible methods of approach. One is to give an extensive series and then wait for two months to get the optimum amount of benefit from the treatment; the other is to give a shorter course of roentgen therapy and follow this either immediately or within a week to ten days by operation. Postoperative Roentgen Therapy: Patients who do not show definite metastases at the time of operation receive only three or four series of six exposures each, administered at intervals of three, four, and six months over three fields: anterior chest, supraclavicular, and axillary regions. Copyrighted by The Radiological Society of North America, Inc.
Radiology – Radiological Society of North America, Inc.
Published: May 1, 1942
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