[Treatment results of breast cancer patients who hoped for breast preservation].
From 1983 to August 1990, 143 patients (148 breasts) were treated with breast conservation therapy in our department. Age ranged from 27 to 75 years (median: 45 years). Forty-one were stage I, 91 were stage II, 6 were stage III, and 5 were stage IV. Surgery consisted of lumpectomy and axillary dissection up to level II. When axillary lymph node(s) were pathologically involved (n(+)), chemotherapy (CMF) was performed. Radiation dose was 50 Gy to the entire breast, and booster irradiation was not performed. After October 1989, patients without palpable axillary node(s) underwent lumpectomy without axillary dissection. Instead, almost all patients started to receive chemotherapy, and not only the breast but also lymph node areas were also included in the radiation field. In 143 patients received conservation therapy, 5-year survival rate was 94%, and 5-year freedom from relapse rate was 81%, respectively. Microscopic surgical margin was positive in 39%. Excluding 5 stage IV patients, 14 relapsed out of 138 patients. Initial relapse sites were as follows: the breast in 3, the axilla 2, the distant organ in 10 patients. One patient relapsed in the axilla and the distant site simultaneously. Distant sites were the lung (4), the bone (4), the bone and the other organs (2). Three stage II patients showed in-breast recurrences. Microscopic surgical margins at initial lumpectomy were positive in one and negative in other 2 patients. One patient was salvaged with re-lumpectomy, and no relapse was seen after that.
Hiramatsu
H
H
Department of Radiology, Keio University, School of Medicine.
Kondo
M
M
Amemiya
A
A
Hashimoto
S
S
D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D015412:Mastectomy, Segmental; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate