Adequate locoregional treatment for early breast cancer may prevent secondary dissemination.

1995 ◽  
Vol 13 (12) ◽  
pp. 2869-2878 ◽  
Author(s):  
R Arriagada ◽  
L E Rutqvist ◽  
A Mattsson ◽  
A Kramar ◽  
S Rotstein
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Distant Metastasis ◽  
Preoperative Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients

PURPOSE To analyze different events that determine event-free survival (EFS) in a randomized trial on adjuvant radiotherapy in early breast cancer patients with more than 15 years of follow-up evaluation. PATIENTS AND METHODS The trial included 960 patients with a unilateral, operable breast cancer. Surgery consisted of a modified radical mastectomy. The trial compared three arms, as follows: preoperative radiotherapy, postoperative radiotherapy, and no adjuvant treatment. Events were analyzed by a competing-risk approach. A proportional hazards multiple regression model was used to analyze the effects of radiotherapy on the risk of distant metastasis. Similar analyses were performed separately for node-negative [N(-)] and node-positive [N(+)] patients in the two groups that did not include preoperative radiotherapy. RESULTS Radiotherapy produced a fivefold decrease of the risk of local recurrence (P < .0001). In N(+) patients, postoperative radiotherapy decreased the risk of distant dissemination (relative risk, 0.63). When local recurrence was introduced in the model as a time-dependent covariate, this factor was predictive of distant dissemination (P < .0001) and nullified the effect of postoperative radiotherapy. This finding suggests that the decrease of distant metastases was related to the prevention of local recurrence. A similar effect was found in models that used overall survival as an end point. CONCLUSION This study shows that postmastectomy radiotherapy in N(+) breast cancer patients may decrease the distant metastasis rate by preventing local recurrences and thus avoiding secondary dissemination.

scholarly journals Postoperative radiotherapy after conservative surgery for early breast cancer: 5-year results

2004 ◽  
Vol 12 (1) ◽  
pp. 29-33
Author(s):  
Jasmina Mladenovic ◽  
Marko Dozic ◽  
Nenad Borojevic
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Systemic Therapy ◽  
Postoperative Radiotherapy ◽  
Breast Conserving Surgery ◽  
Breast Cancer Patients ◽  
Disease Free

BACKGROUND: Breast conserving surgery followed by postoperative radiotherapy, as alternative to radical mastectomy, has been accepted as an optimal method for loco- regional treatment of the majority of women with early stage of breast carcinoma. The aim of the study was to evaluate the results of postoperative radiotherapy after breast conserving surgery in the Institute for oncology and radiology of Serbia. METHODS: During the 3-year period, 109 breast cancer patients with stage I and II were treated with postoperative radiotherapy after breast conserving surgery. Ninety- four patients underwent quadrantectomy with axillary node dissection, and 15 patients underwent only tumorectomy. After surgery all patients received postoperative radiotherapy to the whole breast with tumor dose 50 Gy in 15 fractions every second day. In 52 patients radiotherapy was given to the regional lymphatics with tumor dose 45 Gy in 15 fractions every second day. Twenty-eight patients received a booster dose (10 Gy) to the tumor bed. Adjuvant systemic therapy was administered depending on the nodal involvement and steroid receptors content: 17 patients received adjuvant chemotherapy (CMF or FAC), 18 received adjuvant hormonal therapy (tamoxifen or ovarian ablation), and 6 patients received both chemo- and hormonotherapy. RESULTS: After median follow-up period of 62 months, there was no evidence of loco- regional recurrence in anyone of patients. Distant metastases occurred in 7 patients (6.4%) with median disease free interval of 27.6 months. At last follow-up 91 patients (83.4%) were alive, 4 patients (3.7%) were dead of disease, and the same number was dead of other causes. The 5-year overall survival rate was 92.9% and disease-free survival rate was 92.7%. CONCLUSION: According to our results the combined surgery and radiotherapy approach provides good local control of early breast cancer patients. Postoperative radiotherapy after breast conserving surgery with or without adjuvant systemic therapy has important role in adjuvant treatment of early breast cancer.

scholarly journals Prevention of Prolonged Lymphorrhea in Minor Pectoral Myoplasty in Women after Breast Cancer Surgery: Anatomical and Physiological Aspects

2020 ◽  
Vol 13 (2) ◽  
pp. 98-102
Author(s):  
Alexandr Vladimirovich Aseev ◽  
Dmitry Anatolyevich Maximov ◽  
Olga Olegovna Suleymanova
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Dead Space ◽  
Radical Mastectomy ◽  
Radical Resection ◽  
Breast Cancer Surgery ◽  
Control Group ◽  
Case Group ◽  
Breast Cancer Patients ◽  
Simultaneous Application

Introduction. Surgery remains the main method of treatment for breast cancer patients. However, in surgery a large number of lymphatic vessels are crossed which inevitably leads to a lymph flow damage. The article discusses the problem of lymphorrhea in breast cancer patients after the radical mastectomy and radical resection. The aim of the study was to assess the effectiveness of minor pectoral myoplasty in the axillary region of the "dead space" for lymphorrhea prevention after radical mastectomy and radical resection.Methods. The case group included 30 patients who underwent 30 surgeries with myoplasty of pectoralis minor (Maddens radical mastectomy or radial resection) in the Tver Oncological Center at the Department of breast pathology from 2016 to 2017. The control group included 30 patients who underwent Maddens mastectomy or radical resection without myoplasty (conventional option).Results. In the case group, during the mastectomy, the patients with lymphorrhea had the drainage removed on the 5,31,2 day. The total amount of the drainage was around 235,43,6 ml. The average daily volume of the drained liquid was 47,12,7 ml. In the control group, during the radical mastectomy without myoplasty, the drainage was removed on the 12,71,4 day. The average total amount of the drained liquid was 1691,632,5 ml. The average daily drained volume was 130,32,5 ml.The patients after radical resection in the case group had the drainage removed on the 5,21,2 day. The total amount of the drained liquid in patients with lymphorrhea was 25 ml/day. The total amount of the drained liquid was 223,711,3 ml. The average daily drained volume was 44,62,3 ml. The patients after radical resection in the control group had the drainage removed on the 11,22,0 day. The average total volume of the drained liquid was 835,526,4 ml. The average daily drained volume was 69,92,2 ml.Conclusion. Application of A. Kh. Ismagilov intraoperative technique dead space closure in minor pectoral myoplasty (patent No. 2385673, issued April 10, 2010) with the simultaneous application of compression garments appears to be a simple and effective method for reducing postoperative lymphorrhea. Myoplasty was effective in reducing lymphorrhea regardless of the type of surgical intervention (radical mastectomy or radical resection). Lymphorrhea duration reduced in more than 2 times.

scholarly journals Effects of Postoperative Radiotherapy in Early Breast Cancer Patients Older than 75 Years: A Propensity-Matched Analysis

2019 ◽  
Vol 10 (25) ◽  
pp. 6225-6232
Author(s):  
Linghui Zhou ◽  
Pengtao Yang ◽  
Yi Zheng ◽  
Tian Tian ◽  
Cong Dai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Postoperative Radiotherapy ◽  
Breast Cancer Patients

Is Survival with Conservative Breast Therapy becoming Superior to that with Modified Radical Mastectomy alone for the Treatment of Early Breast Cancer in this Era?

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 24-24
Author(s):  
Mona M Sayed
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Disease Free Survival ◽  
Radical Mastectomy ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Disease Free

Purpose: This study aims to assess survival rates in early breast cancer patients treated by Conservative breast therapy (CBT), including radiotherapy, compared to those treated by modified radical mastectomy (MRM) alone. Methods: The South Egypt Cancer Institute and the Assiut University Oncology Department patients’ records, from January 2010 to December 2017, were searched for T1-2N0-1M0 breast cancer patients treated by CBT or MRM. Patients who didn’t receive chemotherapy were excluded to reduce the treatment variation. Results: The five-year locoregional disease free survival (LRDFS) was 97.3% for the CBT patients was and 98.0% for the MRM patients (P=.675). The five-year distant disease free survival (DDFS) was 93.6% for CBS and 85.7% for MRM (P=0.033). The DFS was 91.9% for the BCT patients and 85.3% for the MRM patients (P=0.045). The five-year OS was 98.2% for the CBT patients and 94.3% for the MRM patients, (P=0.02). By Cox regression analysis, the CBT resulted in significantly better OS, (p=0.018) and the (HR=0.350, 95% CI 0.146-0.837). The adjusted OS, estimated by the propensity-score based weights, remained superior in CBT than in MRM patients (p < 0.001). Conclusion: CBT resulted in better DDFS, DFS and OS than MRM. Future randomized trials are needed to confirm these findings and determine the cause.

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