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J Korean Soc Ther Radiol Oncol > Volume 22(3); 2004 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2004;22(3): 192-199.
The 1998, 1999 Patterns of Care Study for Breast Irradiation After Breast-Conserving Surgery in Korea
Chang Ok Suh, Hyun Soo Shin, Jae Ho Cho, Won Park, Seung Do Ahn, Kyung Hwan Shin, Eun Ji Chung, Ki Chang Keum, Sung Whan Ha, Sung Ja Ahn, Woo Cheol Kim, Myung Za Lee, Ki Jung Ahn, Doo Ho Choi, Jin Hee Kim, Kyung Ran Park, Kang kyoo Lee, Seunghee Kang, Mi Hee Song, Do Hoon Oh, Jae Won Lee, II Han Kim
1Yonsei University College of Medicine, Korea. cosuh317@yumc.yonsei.ac.kr
2Pochon CHA University College of Medicine, Korea.
3Sungkyunkwan University School of Medicine, Korea.
4Ulsan University College of Medicine, Korea.
5National Cancer Center, Korea.
6National Health Insurance Corporation Ilsan Hospital, Korea.
7Seoul National University College of Medicine, Korea.
8Chunnam National University College of Medicine, Korea.
9Inha University College of Medicine, Korea.
10Hangyang University College of Medicine, Korea.
11Dong A University College of Medicine, Korea.
12Soon Chun Hyang University College of Medicine, Korea.
13Keimyung University College of Medicine, Korea.
14Yonsei University Wonju College of Medicine, Korea.
15Wonkwang University College of Medicine, Korea.
16Ajou University College of Medicine, Korea.
17National Medical Center, Korea.
18Hallym University College of Medicine, Korea.
19Statistics, Korea University, Korea.
ABSTRACT
PURPOSE:
To determine the patterns of evaluation and treatment in the patient with early breast cancer treated with conservative surgery and radiotherapy and to improve the radiotherapy techiniques, nationwide survey was performed.
MATERIALS AND METHODS:
A web-based database system for Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Two hundreds sixty-one randomly selected records of eligible patients treated between 1998~999 from 15 hospitals were reviewed.
RESULTS:
The patients ages ranged from 24 to 85 years(median 45 years). Infiltrating ductal carcinoma was most common histologic type (88.9%) followed by medullary carcinoma (4.2%) and infiltrating lobular carcinoma (1.5%). Pathologic T stage by AJCC was T1 in 59.7% of the casses, T2 in 29.5% of the cases, Tis in 8.8% of the cases. Axillary lymph node dissection was performed in 91.2% of the cases and 69.7% were node negative. AJCC stage was 0 in 8.8% of the cases, stage I in 44.9% of the cases, stage IIa in 33.3% of the cases, and stage IIb in 8.4% of the cases. Estrogen and progesteron receptors were evaluated in 71.6%, and 70.9% of the patients, respectively. Surgical methods of breast-conserving surgery was excision/lumpectomy in 37.2%, wide excision in 11.5%, quadrantectomy in 23% and partial mastectomy in 27.5% of the cases. A pathologically confirmed negative margin was obtained in 90.8% of the cases. Pathological margin was involved with tumor in 10 patients and margin was close (less than 2 mm) in 10 patients. All the patients except one recieved more than 90% of the planned radiotherapy dose. Radiotherapy volume was breast only in 88% of the cases, breast+supraclavicular fossa (SCL) in 5% of the cases, and breast+SCL+posterior axillary boost in 4.2% of the cases. Only one patient received isolated internal mammary lymph node irradiation. Used radiation beam was Co-60 in 8 cases, 4 MV X-ray in 115 cases, 6 MV X-ray in 125 cases, and 10 MV X-ray in 11 cases. The radiation dose to the whole breast was 45~9.4 Gy (median 50.4) and boost dose was 8~20 Gy (median 10 Gy). The total radiation dose delivered was 50.4~70.4 Gy (median 60.4 Gy).
CONCLUSION:
There was no major deviation from current standard in the patterns of evaluation and treatment for the patients with early breast cancer treated with breast conservation method. Some varieties were identified in boost irradiation dose. Separate analysis for the datails of radiotherapy planning will be followed and the outcome of treatment is needed to evaluate the process.
Key Words: Breast cancer, Breast-conserving treatment, Radiotherapy
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