Indications of breast preserving surgery without radiation

Breast preserving surgery has become a standard therapy for early breast cancer. Breast conserving therapy with radiation has been recognized as a standard strategy, because of the low incidence of local failure and minimal postoperative deformity compared with that of quadrantectomy without radiation. Among cases treated with breast preserving surgery, surgical resection alone may be sufficient for local control. We have experienced 11 cases of local failure from 108 cases who were treated with quadrantectomy. The ability of local control with quadrantectomy was analized. Among 11 cases with local failure, 3 cases had an apparently small resection area, and 3 cases had multiple tumors. In the other five cases, intraductal component was observed in primary tumor, 2 out of the five cases had EIC, and 3 of the five cases relapsed around the areola. After close analysis and modification of indication criteria, we could reduce the recurrence rate of late 66 cases to less than 2%. For local failure cases, seven cases were treated with total mastectomy, 4 with partial mastectomy, and no further relapse resulted. Our data indicated that quadrantectomy is effective and safe for local control if its indication is carefully determined.