Preoperative irradiation for locally advanced breast cancer

Abstract

The rationale for preoperative irradiation is sound: eradication of sensitive tumor cells at the periphery of a lesion making complete resection more likely and dissemination of tumor cells by operative manipulation less likely. The dose of irradiation required to achieve this is approximately 80 to 85% of the dose needed to permanently control palpable disease, a dose which does not interfere with subsequent mastectomy healing if 3 to 4 weeks elapse between the conclusion of irradiation and mastectomy. Literature review of series dating back to 1921 indicates that for locally advanced or regionally advanced breast cancer, the preoperative irradiation does reduce local recurrence and probably improves survival as well. A prospective controlled clinical trial to evaluate this more conclusively is needed. Such a trial will require harmonious and honest cooperation between surgeons and radiotherapists.

The Dilemma of Stage Iii Breast Cancer: A Study of Preoperative Radiotherapy

“…. literature review of series dating back to 1921 indicates that, for locally or regionally advanced breast cancer, preoperative irradiation does reduce local recurrence, and probably improves survival as well" ( Caldwell, 1971). The treatment of some Stage 111 tumours is particularly difficult to plan.…”