Tumorectomy plus radiotherapy in the management of breast cancer

From 1974 to 1982 a total of 58 patients with locoregional breast cancer, judged not suitable for demolitive surgery because of old age, bad general conditions or other reasons, were treated with simple tumorectomy followed by radiotherapy. The median age of the patients was 71 years. Two patients had synchronous bilateral breast cancer, both treated with the same conservative approach. Thirty-three tumors were classified as T1, 24 as T2, 1 as T3, and 2 as T4 of a small size. The median size of the tumor was 2 cm; mean size was 2.24 cm. Radiotherapy was given to the whole breast, followed by a conedown on the tumor bed. The median dose to the tumor bed was 64 Gy, over 7-9 weeks. Thirty-two patients received irradiation on nodal sites too, up to 45-60 Gy. The median follow-up for the whole series was 44 months. Only 4 of 60 treated breasts have presented a local recurrence (6.6%); relapse-free survival at 3 and 5 years is 85.4% and 79%, respectively. Our results confirm that tumorectomy followed by radiotherapy appears to be a very effective alternative to radiotherapy alone and to demolitive surgery. In fact, local control, survival and cosmetic results are quite satisfactory and achievable through a simple therapeutic modality.