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J Korean Soc Ther Radiol Oncol > Volume 26(3); 2008 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2008;26(3): 142-148. doi: https://doi.org/10.3857/jkstro.2008.26.3.142
Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer
Eui Kyu Chie, Kyubo Kim, Jin Hwa Choi, Na Young Jang, Wonshik Han, Dong Young Noh, Seock Ah Im, Tae You Kim, Yung Jue Bang, Sung Whan Ha
1Department of Radiation Oncology, Medical Research Center, Seoul National University, Seoul, Korea. swha@snu.ac.kr
2Department of Surgery, Medical Research Center, Seoul National University, Seoul, Korea.
3Department of Internal Medicine, Seoul National University College of Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
4Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.
A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months.
The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival.
This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.
Key Words: Breast cancer, Breast conserving surgery, Radiotherapy
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