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Breast conserving treatment without radiotherapy.

K Takahashi1, M Makita, T Tada

  • 1Department of Breast Surgery, Cancer Institute Hospital, 1-37-1 Kami-ikebukuro, Toshima-ku, Tokyo 170-8455, Japan. ru-kaoru@mvd.biglobe.ne.jp

Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie
|December 19, 2002
PubMed
Summary
This summary is machine-generated.

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Breast conserving surgery without radiotherapy may be safe for select patients. Careful pathological examination ensures negative margins, reducing recurrence risk and allowing safe breast conserving treatment (BCT).

Area of Science:

  • Oncology
  • Surgical Oncology
  • Radiotherapy

Background:

  • Radiotherapy (RT) is a standard adjuvant treatment after breast conserving surgery (BCS) to prevent ipsilateral breast recurrence.
  • The necessity of RT in all BCS cases is questioned, particularly when margins are clear and no residual cancer is found.
  • The risk of a second primary breast cancer in the remaining breast is theoretically similar to contralateral breast cancer risk.

Purpose of the Study:

  • To evaluate the safety and efficacy of omitting RT after BCS in patients with pathologically confirmed clear surgical margins.
  • To compare ipsilateral breast tumor recurrence rates and second primary breast cancer rates in patients treated with or without RT.

Main Methods:

  • A retrospective analysis of 827 patients who underwent BCS without RT from 1986 to 1998.

Related Experiment Videos

  • Patients had undergone strict serial pathological examination of surgical specimens to ensure negative margins.
  • Outcomes, including ipsilateral breast recurrence and second primary cancers, were compared to a cohort of 406 patients treated with RT.

    • Main Results:

    • An ipsilateral breast cancer rate of 5.6% was observed over a median follow-up of 67 months in the no-RT group.
    • This included 2.3% recurrence and 3.3% second primary cancers.
    • The recurrence rate was comparable to the 1.7% rate in patients who received RT, with most failures in the no-RT group having positive margins.

    Conclusions:

    • Omitting RT after BCS is safe for selected patients with pathologically clear margins.
    • Careful pathological assessment is crucial for patient selection to minimize recurrence risk.
    • This approach supports personalized breast cancer treatment strategies.