[Radiotherapy--an alternative to surgery in the treatment of breast cancer].
Patients with breast cancer are treated with radiotherapy alone for one of three reasons: either surgery is impossible (inoperable cases due to locoregional extension, patient status, patient refusal), there is an undeniable benefit (metastasis at diagnosis) or a conservative treatment would be possible if surgery is avoided (which, in France, is currently the case for operable tumours larger than 3 cm inaccessible to a combination tumorectomy/radiotherapy). Radiotherapy can also be used instead of surgery to reach an identical satisfactory result; i.e. locoregional control of the cancer and an aesthetic result of satisfactory quality. Actually, when the alternative offers a real benefit for the patient, radiotherapy alone should be entertained, particularly for tumours classically treated by primary mastectomy (T > 3 cm). For a long time, it was difficult to achieve both efficacity and good tolerance with radiotherapy. In addition, one could not be certain that survival rates were the same for conservative and radical treatments. But since then, randomized and non-randomized comparisons have shown that the conservative or radical nature of the treatment has no effect on survival. Radiotherapy is now better tolerated due to lower total doses which were sometimes too high due to the unjustified reputation of radioresistance. Radiotherapy is thus an alternative to surgery in operable cases, offering conservative treatment and the possibility of delayed surgery if needed. Thus one cannot speak of treatment without surgery since an operation is programmed if required. The treatment can also begin with routine axillary dissection both as a therapeutic and diagnostic procedure.(ABSTRACT TRUNCATED AT 250 WORDS)
Baillet
F
F
Pitié-Salpêtrière, Cancérologie-Radiothérapie, Paris.
D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans
La radiothérapie--alternative à la chirurgie dans le traitement du cancer du sein.