title: Radiotherapy with and without chemotherapy after breast conservation surgery for early stage breast cancer: a review of timing.
abstract: OBJECTIVE
  To evaluate the effects in women of the timing of breast irradiation (BI) in relation to the application or non-application of adjuvant chemotherapy after breast conservation surgery (BCS) for early stage cancer.
  
  
  METHODS
  Between October 1981 and June 1995, 47 women with stage I and II breast cancer underwent BCS. Twenty-six patients did not receive adjuvant chemotherapy (NAC) and 21 women did (AC). In the NAC group, BI commenced within (n = 9) or after (n = 17) seven weeks following BCS; in the AC group, 18 women received BI more than 24 weeks after BCS and three patients within 24 weeks.
  
  
  RESULTS
  In the NAC group, there was a trend toward more local and systemic failures plus a definite correlation with poorer survival (p = 0.05) when BI was initiated more than 7 weeks after BCS. In the AC group, the locoregional and systemic failures occurred only in women with a delay of BI exceeding 24 weeks; survival was not different between the subgroups.
  
  
  CONCLUSIONS
  An undue delay of BI should be avoided in patients after BCS whether they require adjuvant chemotherapy for early stage breast cancer or not.
authors.affiliation: Division of Radiation Oncology, Louisiana State University School of Medicine, Shreveport 71130, USA.
authors.forename: F L
authors.initials: FL
authors.lastname: Ampil
authors.forename: G V
authors.initials: GV
authors.lastname: Burton
authors.forename: B D
authors.initials: BD
authors.lastname: Li
authors.forename: G M
authors.initials: GM
authors.lastname: Mills
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome