Results of conservative surgery for limited-sized infiltrating breast cancer: Analysis of 962 tested patients: 24 years of experience

Abstract

These results unquestionably confirm the validity of BCT, provided certain prerequisites are fulfilled.

Intra-mammary tumor location does not influence prognosis but influences the prevalence of axillary lymph-node metastases

“…1 Kaplan-Meier diseasefree survival analysis among patients with medial or lateral tumor location mammary location of breast tumor and its relationship with axillary lymph-node involvement, which was significantly associated with lateral tumor site (P<0.0001) (Fowble et al 1992;Kambouris 1996;Lohrisch et al 2000;Vitucci et al 2000;Zucali et al 1998). However, the results of the present study challenge two recent reports, which found a correlation between medial tumor location and increased risk of relapse and breast cancerassociated mortality (Lohrisch et al 2000;Zucali et al 1998).…”

“…Five previous studies, comprising altogether 9,834 patients, unanimously demonstrated a clear correlation between medial tumor site and a lower number of axillary lymph-node metastases (Fowble et al 1992;Lohrisch et al 2000;Schnitt et al 1984;Vitucci et al 2000;Zucali et al 1998). No association between the tumor site and the number of axillary lymph-node metastases was detected in only one series of patients at the National Cancer Institute of Milan, Italy (Cascinelli et al 1987).…”

“…These metastases are also influenced by the intra-mammary location of the tumor. It is widely accepted that patients with medial tumor location are at significantly lower risk for axillary lymph-node involvement than patients with tumors in the lateral hemisphere of the breast (Fowble et al 1992;Kambouris 1996;Lohrisch et al 2000;Vitucci et al 2000;Zucali et al 1998).…”

“…While some studies showed not only an influence of the tumor site on the axillary lymph-node status, but also on disease-free and overall survival, (Gaffney et al 2003;Lohrisch et al 2000;Zucali et al 1998), other studies denied a prognostic relevance of the tumor location (Fowble et al 1992;Vitucci et al 2000). Furthermore, it remains unclear whether the increased risk for relapse in patients with medial tumor location in some studies (Lohrisch et al 2000;Zucali et al 1998) might be caused by a treatment bias based upon the difference in axillary lymph-node involvement.…”

Three-dimensional conformal breast irradiation in the prone position

“…The management of primary breast cancer with conservative surgery and radiation therapy is a widely accepted alternative to mastectomy (1,2). However, standard tangential breast radiotherapy not only treats portions of the chest wall, but also exposes lung and heart tissue to radiation (3,4).…”