title: Is radiotherapy needed after breast conservation for small invasive breast cancers?
abstract: OBJECTIVE
  The purpose of this study was to determine the rate of local recurrence in patients with small invasive breast cancers (<1 cm) who had been treated with breast-conserving surgery either with (group 1) or without (group 2) adjuvant radiotherapy.
  
  
  METHODS
  This is a retrospective study of 110 patients with an invasive breast cancer less than 1 cm in size, treated in our centre by breast-conserving surgery. Parameters examined included age at and mode of presentation, histopathological features, adjuvant therapy, length of follow-up and outcome in terms of local recurrence rate and death.
  
  
  RESULTS
  In group 1 there were 59 women of median age 57 (38-80) years. The median tumour size was 9 (1-10) mm and median follow-up was 74 (15-110) months. There were no local recurrences. In group 2 the median age at presentation was 59 (48-81) years. The median tumour size was 7 (2-10) mm and median follow-up was 47 (14-93) months. There were three non-breast-cancer related deaths and three local recurrences (6%).
  
  
  CONCLUSIONS
  A local recurrence rate of 6% at almost 4 years median follow-up suggests that it may be possible to avoid adjuvant radiotherapy in a subgroup of largely screen-detected, node-negative patients with invasive tumours less than 1 cm, in whom adequate local excision is performed. Further follow-up is required to substantiate this.
authors.affiliation: St Bartholomew's Hospital, West Smithfield, London, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Athow
authors.forename: J M
authors.initials: JM
authors.lastname: Gattuso
authors.forename: N
authors.initials: N
authors.lastname: Perry
authors.forename: C
authors.initials: C
authors.lastname: Wells
authors.forename: N
authors.initials: N
authors.lastname: Dutt
authors.forename: G M
authors.initials: GM
authors.lastname: Bahsir
authors.forename: G
authors.initials: G
authors.lastname: Mair
authors.forename: R
authors.initials: R
authors.lastname: Carpenter
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008327:Mammography; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D019564:Unnecessary Procedures