Conservative surgery and radiation therapy for invasive lobular carcinoma of the breast.
BACKGROUND
There is debate as to whether infiltrating lobular carcinoma (ILC) can be effectively treated with breast conservative surgery (CS) and radiotherapy (RT) because of a perceived high risk of local recurrence. This retrospective study examined the outcome of patients with ILC treated by CS and RT.


METHODS
Between November 1979 and December 1994, 57 women with UICC Stage I or II ILC were treated by CS and RT at Westmead Hospital, New South Wales, Australia. The median age was 55 years (range 28-79). Twelve patients (21%) underwent a re-excision after initial CS. The final margins were clear for 43 patients (75.4%), positive (invasive or in situ) for nine patients (15.8%), and indeterminate for five patients (8.8%). All patients received whole-breast irradiation (45-50.4 Gy) usually supplemented by a boost (10-30 Gy). Fifty-three of 57 patients (93%) had their pathology reviewed at Westmead Hospital.


RESULTS
After a median follow up of 69 months (range 36-162) three patients (5.3%) developed a local recurrence. One of 43 patients (2.3%) with known clear margins developed a local recurrence compared with two of 14 patients (14.3%) with positive or indeterminate margins (P = NS). The 5- and 10-year rates of freedom from local recurrence were 96 and 93%, respectively. The 5-year disease-free survival was 85% (node-negative, 92%; node-positive, 66%). Overall survival was 94% at 5 years. No patient developed a contralateral breast cancer.


CONCLUSIONS
Patients with ILC can be effectively treated with CS and RT.
Division of Radiation Oncology, Westmead Hospital, and NSW Breast Cancer Institute, University of Sydney, New South Wales, Australia.
M
M
Francis
B
B
Cakir
M
M
Bilous
O
O
Ung
J
J
Boyages
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy* / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome