Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Ann Surg Oncol Early Release, published online ahead of print Feb 9 2004
Annals of Surgical Oncology, 10.1245/ASO.2004.07.001
 © 2004 Society of Surgical Oncology
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lee, S. H.
Right arrow Articles by Cady, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lee, S. H.
Right arrow Articles by Cady, B.
Related Collections
Right arrow Radiation Therapy

Original Articles

Avoidance of Adjuvant Radiotherapy in Selected Patients With Invasive Breast Cancer

Susan H. Lee, MD, Maureen A. Chung, MD, PhD, David Chelmow, MD, Blake Cady, MD

From The Breast Health Center, Program in Women’s Oncology, Women & Infants’ Hospital of Rhode Island, Providence, Rhode Island (SHL, MAC, BC); Department of Surgery, Brown University School of Medicine, Providence, Rhode Island (MAC, BC); and Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, Tufts-New England Medical Center, Boston, Massachusetts (DC).

Address correspondence and reprint requests to: Blake Cady, MD, University Surgical Associates-APC 120, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903; Fax: 401-868-2313.


  Abstract

Background: Current standard therapy for invasive breast carcinoma is mastectomy or breast conservation with adjuvant radiation. Data from randomized trials suggest no advantage for radiotherapy after lumpectomy in highly selected patients. Selective radiotherapy would make contemporary breast cancer therapy more rational with decreased morbidity and expense.

Methods: A total of 163 patients were treated by breast conservation without adjuvant radiation between 1978 and June 2003. They declined radiation after discussion or had medical contraindications. The great majority were postmenopausal and had lower-grade T1 tumors with resection margins >=1 cm and no nodal metastases. The goal was to identify patients with favorable prognostic features for omission of postsurgical irradiation without impaired local recurrence or survival.

Results: Twenty patients (12%) had local recurrences; 17 (10%) were invasive, and 3 (2%) were ductal carcinoma-in-situ. An ideal patient subgroup >50 years of age with grade 1 or 2 cancers <=1.5 cm in diameter and with surgical margins >=1 cm was empirically defined. Of 80 such patients, 5 (6%) had local recurrence; 3 (3.5%) were invasive, and 2 (2.5%) were ductal carcinoma-in-situ.

Conclusions: A defined ideal subset of older breast cancer patients with smaller, lower-grade cancers and adequate excision margins can be treated with lumpectomy without irradiation and with minimal local recurrence.

Key Words: Breast cancer, Radiation, Recurrence, Lumpectomy




This article has been cited by other articles:


Home page
 Ann. Surg. Oncol.Home page
B. Cady
Simplification of Breast Cancer Surgery
Ann. Surg. Oncol., January 1, 2005; 12(1): 6 - 8.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2004 by the Society of Surgical Oncology.