Breast conservation therapy. The St. Luke's Hospital experience

Between 1979 and 1987, 170 patient with stages 0, I and II breast cancer were treated with breast conservation therapy. Twenty-eight women (16%) had intraductal carcinomas, 110 (65%) stage I disease and 32 (19%) had stage II breast cancers. Seventy-five percent of the patients received no adjuvant systemic treatment, whereas 20% received adjuvant chemotherapy and 5% were given Tamoxifen. All patients received radiation therapy to the breast after lumpectomy and, when appropriate, axillary dissection. Twelve patients (7%) recurred within the treated breast, whereas two patients (1%) recurred in regional lymph nodes. Fourteen women (8%) developed distant metastases and seven women (4%) developed contralateral breast cancer. The actuarial 5 year disease-free survival was 92% for the patients with intraductal carcinoma, 90% for T1 and 65% for T2 patients. Overall actuarial survival was 100%, 96% and 87%, respectively. The St. Luke's Hospital results are comparable to those reported in the literature. We conclude that breast conservation therapy, including irradiation, is an alternative to modified radical mastectomy and that this option should be thoroughly discussed with the patient.