Conservative surgery and definitive radiation therapy for early breast cancer

Fifty-six patients with clinical Stage I and II breast cancer were treated at Crawford Long Hospital of Emory University with conservative surgery and definitive radiation therapy between the years 1978-1987. All patients had pathologic examination of their lymph nodes except for four patients who had their axillae clinically staged only. All patients received definitive radiation therapy with doses in the range of 45-60 Grays. Boost to the site of the primary was done by electrons, and 10-20 Grays were given. Overall actuarial 5-year survival was 77.8% and disease-free survivals were 69.1% and 64.5% at 5 and 7 years respectively. The actuarial survival for Stage I patients was 77.6% at 5 years with a disease-free survival of 71.1% at 5 years. For Stage II patients, it was 78.7%, with a disease-free survival of 66.3% at 5 years. The most common complication was asymptomatic apical pulmonary fibrosis in 3/50 patients. The overall complication rate was 9%.