Local control of breast cancer with tumorectomy plus radiotherapy or radiotherapy alone

58 cases of breast cancer treated primarily by radiotherapy were evaluated to determine the optimum dose for local control. Of 36 patients with T1 + T2 lesions who had tumorectomy prior to radiotherapy, incomplete excision of tumor was demonstrated on microscopic examination in 18. The minimum tumor dose to the breast was 4,500 rads in 5 weeks. Treatment failed to control local tumor in only 2 (5%) and metastases in 1.26 (72%) remained disease-free for 2 to 9 years. Of the 22 patients with T3 + T4 lesions, treatment failed to control both local tumor and metastases in 12 (54%); in those who received 6,000 rads or less in 6 weeks, treatment failed to control any of these lesions. 4,500-5,500 rads controlled the tumor in 95% of those with NO + N1 disease, compared to only half of those with N2 + N3 tumors.