Long‐term results of neoadjuvant radiation therapy for breast cancer

Abstract

SUMMARY Our aim was to determine the long-term outcome and the possible role of neoadjuvant (preoperative) radiation therapy for breast cancers unsuitable for primary conservative surgery. From 1977 to 1992, 75 unifocal non-inflammatory and non-metastatic T2 and T3 breast cancers were treated in our department. All these patients underwent initial radiotherapy, followed by secondary limited surgery. A population of 74 patients, aged from 32 to 82 years (median 56 years), presenting 49 T2 and 26 T3 tumors, was studied. Seventy-two patients (96%) underwent secondary tumorectomy and three patients (4%) reduction mammaplasty. The secondary tumorectomy was followed by a postoperative boost. There were nine recurrences, treated by mastectomy in eight cases and by tumorectomy in one case. Twenty-five patients showed secondary dissemination. Forty-seven patients are still alive and free of disease. The cosmetic results were considered excellent or satisfactory in 71 cases. Under good conditions, preoperative radiotherapy (as well as preoperative chemotherapy) allows the possibility of conservative surgery for cancers of more than 3 cm. The choice between the two modalities depends on the patient's condition and on a precise analysis of all prognostic factors that would justify the need for systemic treatment.

Neoadjuvant radiotherapy of early-stage breast cancer and long-term disease-free survival

“…In general, neoadjuvant RT for early-stage breast cancer would be prescribed to debulk tumors close to the skin or chest wall before surgery. Information about other systemic therapies is also not recorded; however, many of the patients with early-stage breast cancer likely received some form of endocrine therapy and/or chemotherapy [5]. …”

Management of Operable Primary Breast Cancer in Older Women

“…In the neoadjuvant setting, a small series including 75 patients aged from 32-82 years were given 45 Gy dose of radiation in 5 weeks preoperatively for operable breast cancer (T2 and T3 disease). All patients then underwent lumpectomy and the pathological analysis of the tumors showed 11% complete remission of the tumors [40]. The results suggest a potential role for radiotherapy as a primary treatment in selected group of patients.…”

Preoperative Radiotherapy Is Not Associated with Increased Post-mastectomy Short-term Morbidity: Analysis of 77,902 Patients

“…5 This has allowed breast-conserving surgery to be performed with enhanced safety and frequency, with rates reaching 43–92%. 6–10 Isolated NRT has also been found to promote favorable long-term survival among women undergoing breast-conserving surgery 11, 12 or mastectomy. 13 …”