Presidential address: Does adjuvant radiotherapy have a role in the postmastectomy management of patients with operable breast cancer-revisited

Edland, Robert W.

doi:10.1016/0360-3016(88)90290-8

Cited by 17 publications

(3 citation statements)

References 53 publications

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“…Breast-conserving therapy, limited surgery followed by high-dose radiation, has been shown to be as effective as modified radical mastectomy for most operable patients (Veronesi et al, 1981). For mastectomy patients, routine post-operative radiotherapy is now usually considered unnecessary (Edland, 1988;Harris & Hellman, 1988). It could be assumed that treatment practice would be influenced by the information from these trials, but empirical data at national and local level are scarce in most countries (Farrow et al, 1992;Chouillet et al, 1994).…”

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confidence: 99%

Changes in use of breast-conserving therapy in years 1978-2000

Koning

Dongen²,

Maas³

1994

Br J Cancer

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Summary The treatment of breast cancer patients has changed rapidly in the past decade, but empirical data at local and national level are scarce. Predicting the consequences of screening for primary treatment is consequently difficult. The aim of this analysis of records on admissions to hospital of women with breast cancer and/or for breast surgery together with a survey of all Dutch radiotherapy departments is to show the change in breast-conserving therapy and other primary treatment before the start of breast cancer screening in The Netherlands. There was a modest increase in breast-conserving therapy after 1981, coinciding with the first publication on its trial, followed by a sharp increase between 1985 and 1990, after the second publication. At the end of that 5 year period, 36% of all women with newly diagnosed invasive breast cancer underwent this type of surgery. Breast-conserving surgery is always followed by radiotherapy, but there has been a clear reduction in post-operative radiation after mastectomy. The percentage of breast-conserving therapy is at present higher in The Netherlands than in the USA. Implementing the Dutch screening programme will result in a maximum increase in breast-conserving therapy at national level of 34%, which stabilises at + 21%, or a 50% maximum increase at local level. The number of women treated by mastectomy will ultimately decrease by 9%. Given the rapidity of change towards the use of breast-conserving surgery, which is enhanced by screening, recent information will be needed in predicting capacity and assessing whether screen-detected women are treated adequately.The treatment of breast cancer patients has changed rapidly in the past decade. Several trials have led to a better understanding of the possible results of different types of primary treatment. Breast-conserving therapy, limited surgery followed by high-dose radiation, has been shown to be as effective as modified radical mastectomy for most operable patients (Veronesi et al., 1981). For mastectomy patients, routine post-operative radiotherapy is now usually considered unnecessary (Edland, 1988;Harris & Hellman, 1988). It could be assumed that treatment practice would be influenced by the information from these trials, but empirical data at national and local level are scarce in most countries (Farrow et al., 1992;Chouillet et al., 1994).At the same time, countries have started to implement breast cancer screening, as trials have shown that a reduction in mortality from breast cancer can be expected for screened women aged 50-69. The impact on the number and type of surgical procedures and radiotherapy will be great as a result of both the temporary increase in the number of women detected with breast cancer and the increase in early cancers (de Koning et al., 1990). Bottlenecks in capacity are expected, but there is a lack of empirical data to support this hypothesis.As we were especially uncertain about the development of breast-conserving therapy (outside a screening programme), we have analysed dat...

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confidence: 99%

Changes in use of breast-conserving therapy in years 1978-2000

Koning

Dongen²,

Maas³

1994

Br J Cancer

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“…Nevertheless, the rate of local recurrence was very low. Various studies have reported that comprehensive RT reduces the rate of local recurrence 23–25, 31, 32, 35–41. In the Danish and Swedish trials, the locoregional recurrence rates decreased from 32% and 30%, respectively, after modified radical mastectomy and chemotherapy, to 9% and 10%, respectively, after adjuvant RT.…”

Section: Discussionmentioning

confidence: 98%

Low risk of locoregional recurrence of primary breast carcinoma after treatment with a modification of the Halsted radical mastectomy and selective use of radiotherapy

Bijker¹,

Rutgers²,

Peterse³

et al. 1999

Cancer

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“…This trial began in 1948, and in the intervening years, a number of randomized prospective trials were completed. [229][230][231][232][233][234][235][236] Although none of these early trials found a clear survival benefit, we now know that there is a significant decrease in chest wall relapse, approaching 5%, when postoperative irradiation is used. 237,238 With the passage of time, an interesting conclusion from the analysis of the many adjuvant chemotherapy trails began to emerge.…”

Section: Which Mastectomy Patients Benefit From Radiation Therapy?mentioning

confidence: 99%

Multimodality Treatment of Breast Cancer

Niederhuber¹

2005

Breast Cancer

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Presidential address: Does adjuvant radiotherapy have a role in the postmastectomy management of patients with operable breast cancer-revisited

Cited by 17 publications

References 53 publications

Changes in use of breast-conserving therapy in years 1978-2000

Changes in use of breast-conserving therapy in years 1978-2000

Low risk of locoregional recurrence of primary breast carcinoma after treatment with a modification of the Halsted radical mastectomy and selective use of radiotherapy

Multimodality Treatment of Breast Cancer

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