title: Breast conservation management of breast tumors 4 cm or larger.
abstract: Randomized studies of stage I and II breast cancer have shown that breast conservation treatment is equivalent to modified radical mastectomy in regard to local-regional control and survival. Little has been published on breast conservation for patients with large tumors. We analyzed 68 patients with tumors measuring 4 cm or larger (range, 4 to 12 cm) treated with breast-conserving surgery and radiation therapy. The median follow-up was 46 months; the mean tumor size was 5 cm. The 5-year actuarial local-regional recurrence rate was 8.5%, and the overall survival and disease-free survival rates were 76% and 68%, respectively. We conclude that breast conservation treatment may be a reasonable alternative to mastectomy in patients with tumors 4 cm or larger without compromise in local-regional control or survival, while achieving acceptable cosmesis.
authors.affiliation: Department of Radiation Oncology, UCLA 90024.
authors.forename: M M
authors.initials: MM
authors.lastname: Khanna
authors.forename: R J
authors.initials: RJ
authors.lastname: Mark
authors.forename: M J
authors.initials: MJ
authors.lastname: Silverstein
authors.forename: G
authors.initials: G
authors.lastname: Juillard
authors.forename: B
authors.initials: B
authors.lastname: Lewinsky
authors.forename: A E
authors.initials: AE
authors.lastname: Giuliano
mesh_terms: D001940:Breast / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental / Q000379:methods; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome