title: Cosmetic results in early breast cancer treated with lumpectomy, peri-operative interstitial irradiation, and external beam radiation.
abstract: Patients with operable breast cancer were treated at the University of Kansas Medical Center with lumpectomy, peri-operative interstitial Iridium, and external beam radiotherapy, and concomitant adjuvant chemotherapy in a majority of node positive cases. Examination of the cosmetic results in 85 breasts followed for at least 2 years, at a median of 41 months revealed 20% to be excellent, 44% to be very good, 24% good, 9% fair, and 4% to have poor results. In this paper cosmesis is analyzed with reference to the size of the primary, its location, age of the patient, whether the patient received adjuvant chemotherapy, and whether the regional nodes were treated. In this group of patients, the size and the site of the primary, patient's age, and whether adjuvant chemotherapy was administered or not, did not adversely affect the aesthetic outcome. Treatment of the regional nodes gave a worse mean cosmetic score compared to the group in whom only the breast was treated (37.51 vs. 58.98 respectively, p less than 0.001). Among the 11 patients with fair/poor cosmesis, all had regional nodal treatment, 7/11 had inner quadrant lesions, and 7/11 had lesions greater than T1. Further follow-up and accrual would be needed to confirm our results and affirm if other factors would change.
authors.affiliation: Department of Radiation Oncology, University of Kansas Medical Center, Kansas City.
authors.forename: L
authors.initials: L
authors.lastname: Krishnan
authors.forename: W R
authors.initials: WR
authors.lastname: Jewell
authors.forename: C M
authors.initials: CM
authors.lastname: Mansfield
authors.forename: E K
authors.initials: EK
authors.lastname: Reddy
authors.forename: J H
authors.initials: JH
authors.lastname: Thomas
authors.forename: E C
authors.initials: EC
authors.lastname: Krishnan
authors.forename: K
authors.initials: K
authors.lastname: Gerald
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D001940:Breast / Q000528:radiation effects / Q000601:surgery*; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008875:Middle Aged; D013997:Time Factors
chemical_list: D007496:Iridium Radioisotopes