11076 Background: The treatment results of patients with locally advanced breast cancer still remain far from satisfactory. Both lack of locoregional control and distant metastases remain the most common pattern of failuire. The aim of this study was to evaluate whether achieving locoregional control decreases the subsequent risk of distant metastases a large series of consecutive locally advanced breast cancer patients managed with radiotherapy as the primary locoregional treatment. Methods: The records of 261 primarily inoperable locally advanced breast cancer patients treated between 1991 and 1997 at two institutions: Medical University of Gdansk, Poland and Velindre NHS Trust, Cardiff, UK were analysed. All patients received megavoltage radiotherapy to the breast with two tangential fields, and the adjacent lymph node areas were irradiated using customised fields. In 241 patients radiotherapy constituted the only local treatment and the remaining 20 patients were subsequently subjected to mastectomy. Most patients received chemotherapy and/or endocrine therapy prior or after radiation therapy. Results: Follow-up ranged from 6 to 133 months (median 37 months). Five- year overall survival was 36% (95%CI: 28–43%) and 5-year loco-regional relapse-free survival was 48% (95%CI: 40–57%). Recurrence occurred in 167 patients (67%), including local recurence in 30 patients (12%), distant metastases - in 72 patients (27%) and both distant and local recurrence - in 65 patients (26%). Median time to distant metastases was significantly shorter among a subgroup of patients who presented locoregional failuire - 33 months as compared to patients who were free of locoregional recurrence or progression before presenting distant metastases-43 months (p<0.05) Conclusions: This study demonstrated that treatment results in patients with locally advanced breast cancer are still far from satisfactory. However it confirmed the importance of putting much effort in achieving locoregional control in that group of patients as it significantly reduces the risk of subsequent distant metastases. No significant financial relationships to disclose.
Breast conservation in locally advanced breast cancer