Selective avoidance of postoperative locoregional radiotherapy in breast cancer seems to be justified.
OBJECTIVE
To try and reduce the amount of routine postoperative radiotherapy that we prescribed without causing an unacceptable rise in locoregional recurrences.


METHODS
Retrospective study.


METHODS
Teaching hospital, The Netherlands.


METHODS
836 women who were treated for breast cancer between January 1980 and December 1989.


METHODS
These 836 had been treated by modified radical mastectomy (n = 534), excision of the tumour and axillary dissection (n = 279), lumpectomy (n = 15), or total mastectomy (n = 8). In December 1984 we stopped giving routine postoperative irradiation to women with T1 or T2 tumours unless there was any doubt about the operative specimen.


METHODS
The rate of locoregional recurrence 1985-9 compared with that from 1980-December 1984.


RESULTS
Only 1 patient of 836 had a clinically detectable recurrence in the internal mammary chain. There were only 2 recurrences in the 235 axillas that had not been irradiated.


CONCLUSIONS
By a process of careful selection of patients for locoregional irradiation, the number of fields of irradiation given to patients with breast cancer can be reduced by up to 80% without causing a rise in the rate of locoregional recurrences.
Leer
J W
JW
Department of Clinical Oncology, University Hospital, Leiden, The Netherlands. JWHReer@Oncology.MedFac.ReidenUniv.nl
Caspers
R J
RJ
van Lonkhuijzen
L R
LR
van Raaij
T M
TM
Elkhuizen
P H
PH
Zwinderman
A H
AH
van de Velde
C J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015411:Mastectomy, Modified Radical; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D012189:Retrospective Studies