Perioperative interstitial irradiation in the conservative management of early breast cancer.
Conservation of the breast in early breast cancer with limited resection and radiation is proving to be as effective as modified radical mastectomy in survival and in loco-regional control. Management at the University of Kansas Medical Center consists of an interstitial implant at the time of lumpectomy to facilitate perioperative irradiation with Iridium-192 to the tumor bed. An axillary node dissection is also performed at that time. Two to 3 weeks later external beam irradiation is delivered to the entire breast. One hundred and twenty-three breasts in 120 patients have been treated between June 1982 and June 1986. There were 49 pathological Stage I, 63 Stage II, 8 Stage III carcinomas, and 3 carcinomas in situ, consisting of 72 T1, 43 T2, 5 T3, and 3 TIS lesions. Patients have been followed for a median of 30 months. One patient had a "true" recurrence in the breast. Another patient developed recurrence in a different quadrant. Ninety percent of the patients had good to excellent cosmetic results, 7% were considered fair, and 3% had poor results. Seven patients developed mild arm edema, 4 were found to have moderate edema, and 1 had severe arm edema. Our preliminary results indicate that interstitial irradiation immediately after excision results in excellent local control, with very satisfactory cosmesis and no morbidity due to the simultaneous excision and irradiation.
Krishnan
L
L
Department of Radiation Oncology, University of Kansas Medical Center, Kansas City 66103.
Jewell
W R
WR
Mansfield
C M
CM
Reddy
E K
EK
Thomas
J H
JH
Krishnan
E C
EC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002278:Carcinoma in Situ / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage; D008197:Lymph Node Excision; D008875:Middle Aged; D011879:Radiotherapy Dosage; D013997:Time Factors
D007496:Iridium Radioisotopes