Radiation therapy with or without primary limited surgery for operable breast cancer: A 20-year experience at the marseilles cancer institute

Abstract

Since 1960 more than 3000 consecutive patients with operable infiltrating breast carcinoma were treated by radiation therapy with or without primary limited surgery, which usually consisted of local excision. For tumors smaller than or equal to 5 cm the ten-year crude survival rate is 77% for patients without palpable axillary nodes (T1-2N0) and 63% for patients having axillary adenopathy (T1-2N0). For operable tumors exceeding 5 cm of diameter (T3N0-1) the ten-year crude survival is 34%. Thirty-five percent of the patients alive free of disease at ten years required a secondary operation for presumed local or regional tumor persistence or recurrence, although no residual disease was found in 24% of the operative specimens. Local-regional recurrence had no adverse effect on ten-year survival. This conservative approach offers most women with operable breast cancer an excellent chance at breast preservation with the same chance for ten-year survival as with radical mastectomy.

Immediate breast reconstruction using autologous free dermal fat grafts provides better cosmetic results for patients with upper inner cancerous lesions

“…This usually involved one or more investigators making a judgment as to whether retraction was absent, slight, moderate, or severe. [51][52][53][54] Vrieling et al 55 evaluated the BRA scoring system for its usefulness in assessing cosmetic outcome and compared it with panel assessment measures. They concluded that the BRA is reliable for evaluating cosmetic outcome and is especially useful for comparing two groups.…”

Radiation therapy for operable breast cancer

“…105 The 1980s saw many single institution studies reported in Cancer with favorable outcomes with BCS with or without radiation, particularly from Europe. [108][109][110][111][112] Although the local failure rates with longterm follow-up of 10 years or more could be 20% or higher, rates were dropping to 10% with treatment of earlier stage disease, smaller tumor sizes, use of wide excision of all gross disease before radiation, and improved radiation techniques and dose. 107,[113][114][115] Pathologic factors of margins, extensive intraductal component (EIC), necrosis, lobular histology, and young age became recognized as important for tumor control with radiation.…”

“Breast Cancers” Recommendations for clinical practice from Saint Paul de Vence

“…L'irradiation axillaire peutelle être proposée en remplacement du curage ou après curage limité, en particulier pour les patientes cliniquement N0 ? Plusieurs études (niveau 1) [7,92,248] montrent que dans ce cas, le taux de récidive axillaire après irradiation exclusive, sans curage, est compris entre de 1 à 3 %. Ces résul-tats sont équivalents à ceux obtenus après un CA.…”