Aichi Cancer Center 10-year experience with conservative breast treatment of early breast cancer: retrospective analysis regarding failure patterns and factors influencing local control.
OBJECTIVE
We analyzed the clinical results of conservative breast therapy in our institute to determine the risk factors influencing local and distant disease recurrence.


METHODS
From 1989 to 1997, 301 breasts of 295 women with early breast cancer were treated with conservative surgery and adjuvant radiotherapy. There were 212 incidences of Stage I breast cancer, and 89 of Stage II. Patients were routinely treated with local resection, axillar dissection, and 46--50 Gy irradiation given in 23--25 fractions. Some also received a radiation boost to the tumor bed.


RESULTS
The 5-/8-year overall survival, disease-free survival, and local control rates were 93.2/91.5%, 86.0/80.6%, and 95.1/92.5%, respectively. Using both univariate and multivariate analyses, tumor volume, estrogen receptor status, and age < 40 years were significant prognostic factors for disease-free survival. Both age < 40 years and surgical method had a strong effect on local control by uni- and multivariate analysis. Surgical margin status was a significant prognostic factor for local control at the univariate level (p < 0.0001), though it had only borderline significance at the multivariate level (p = 0.08). No patient experienced severe morbidity due to radiotherapy.


CONCLUSIONS
The results obtained are comparable to previously reported data. Although the follow-up period was too short to draw definite conclusions about long-term outcomes, the outcome from conservative breast treatment was acceptable.
Kodaira
T
T
Department of Therapeutic Radiology, Aichi Cancer Center, Nagoya, Aichi, Japan. yra05712@nifty.ne.jp
Fuwa
N
N
Itoh
Y
Y
Matsumoto
A
A
Kamata
M
M
Furutani
K
K
Sasaoka
M
M
Miura
S
S
Takeuchi
T
T
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D017211:Treatment Failure