Long-term complications associated with breast-conservation surgery and radiotherapy.
BACKGROUND
Breast-conservation surgery plus radiotherapy has become the standard of care for early-stage breast cancer; we evaluated its long-term complications.


METHODS
We selected patients treated with surgery and radiotherapy between January 1990 and December 1992 (an era in which standard radiation dosages were used) with follow-up for at least 1 year. Patients were prospectively monitored for treatment-related complications. Median follow-up time was 89 months.


RESULTS
A total of 294 patients met the selection criteria. Grade 2 or higher late complications were identified in 29 patients and included arm edema in 13 patients, breast skin fibrosis in 12, decreased range of motion in 4, pneumonitis in 2, neuropathy in 2, fat necrosis in 1, and rib fracture in 1. Arm edema was more common after lumpectomy plus axillary node dissection than after lumpectomy alone. Arm edema occurred in 18% of patients who underwent surgery plus irradiation of the lymph nodes and 10% who underwent surgery without nodal irradiation.


CONCLUSIONS
Breast-conservation surgery plus radiotherapy was associated with grade 2 or higher complications in only 9.9% of patients. Half of these complications were attributable to axillary dissection, it is hoped that lower complication rates can be achieved with sentinel lymph node biopsy. Breast-conservation surgery and radiotherapy is associated with grade 2 or greater complications in only 9.9% of patients. Nearly half of these complications are attributable to axillary dissection.
Meric
Funda
F
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Buchholz
Thomas A
TA
Mirza
Nadeem Q
NQ
Vlastos
Georges
G
Ames
Frederick C
FC
Ross
Merrick I
MI
Pollock
Raphael E
RE
Singletary
S Eva
SE
Feig
Barry W
BW
Kuerer
Henry M
HM
Newman
Lisa A
LA
Perkins
George H
GH
Strom
Eric A
EA
McNeese
Marsha D
MD
Hortobagyi
Gabriel N
GN
Hunt
Kelly K
KK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology; D015412:Mastectomy, Segmental; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D018709:Statistics, Nonparametric; D013781:Texas / Q000453:epidemiology