[Conservative treatment of stage I-II breast carcinoma. Side-effects and esthetic results]

A good cosmetic result is one of the main goals in conservative breast cancer treatment (quadrantectomy plus radiotherapy and, sometimes, adjuvant chemotherapy). In a retrospective study on 302 patients treated at Cremona Hospital Radiotherapy Department, a group of 68 patients was selected because of its homogeneity: all these patients had been operated by the same surgeon and irradiated according to the same technical rules. Acute reactions, late side-effects and cosmetic results are analyzed in this group. Acute postoperative complications were seen in 15% of the cases and late or persistent changes in 54%. Radiotherapy caused acute reactions in 73.5% of the cases and late side-effects in 47%. An acceptable cosmetic result was obtained in 95.5% of the patients: an excellent result in 31%, a good result in 41% and a sufficient one in 23.5%. The dose to whole breast, the dose to the quadrant and the kind of boost have no influence on the cosmetic results, while concomitant chemotherapy (p = 0.028) and high inhomogeneity in dose distribution (p = 0.04) caused a worse outcoming. The authors believe that better results may be obtained by improving treatment planning (to reduce inhomogeneity) and by optimizing chemotherapy and radiotherapy combination.