No abstract

Between January 1947 and the end of 1976, of 2076 patients with Stages I and II breast cancer treated at M. D. Anderson Hospital, 126 received treatment for cancer in both breasts. Records of 94 patients who had only one cancer treated at U. T. M. D. Anderson Hospital and in whom staging and treatment details were not available and records of the patients who developed local, regional, or systemic failure prior to the diagnosis of the second breast were excluded. Of 126 patients with bilateral breast cancer, 39 had simultaneous tumors (both cancers diagnosed within six months) and 87 had consecutive tumors. The disease‐free 20‐year survival rate shows no significant difference between patients with unilateral tumors and those with bilateral simultaneous or consecutive tumors. Analysis by radiotherapy modality or surgery alone shows, if anything, a lower incidence of cancer in the second breast in the irradiated patients, indicating that in patients with Stage I or Stage II lesions, the doses of radiation given in the management of the first breast cancer were not conducive to the development of a cancer in the remaining breast.

No abstract

No abstract

In 1963 an electron beam became available, making irradiation of the chest wall technically easy. In addition to peripheral lymphatic irradiation in patients with positive axillary nodes and/or the tumor in the inner quadrants or centrally located, patients with tumor larger than 5 cm or with grave signs and/or a significant incidence of positive axillary nodes received chest wall irradiation. None of the patients has received elective chemotherapy. Disease-free survival rates at ten years are 54% for the overall group, 79% for the patients with negative nodes, 44% for patients with positive nodes, 61% for patients with 1-3 positive nodes, and 33% for patients with four or more positive nodes. The incidence of peripheral lymphatic failures is low as well as the incidence of failures on the chest wall in the patients having had chest wall irradiation. With the availability of electron beam and adjustments in doses, complications are nonexistent. The incidence of treatment failures, local-regional, or distant, that have appeared by ten years are compared with the incidence of failures that were experienced by the placebo patients in the clinical trial of the NSABP of thio-TEPA versus placebo. The clearly lesser incidence of treatment failures in the U.T.M.D. Anderson Hospital patients either suggests that postoperative irradiation may have survival benefits or that the data of the NSABP series are not representative of all series.