Introduction: Radiotherapy (RT) in conservative treatment for breast cancer (CT-BC) has been proven to be a determinant for the local control of the disease. Radiation therapy was described by several authors as the most important factor affecting the cosmetic results of this treatment. Technical progress in RT, use of filters and wedges and an increased knowledge of the influence of fraction size total dose and irradiated volume on breast tissues contributed to avoid major radiotherapeutic side effects in the CT-BC. Patients and methods: Cosmetic outcome from 2 groups of patients (pts) with breast cancer in stage T 1-2 (T > 2.5 cm) N 0-1 M 0 of the prospective trial Milan III were compared. Both groups of pts (n = 89) were treated with quadrantectomy and axillary dissection. 49 pts received complementary RT with a dose of 50 Gy over 5 weeks with a daily fraction of 2 Gy and a further boost of 10 Gy (10 MeV electrons) on the scar. Remaining 40 pts did not receive RT. Cosmetic results were subjectively and objectively (asymmetry index) evaluated. Results: No significant cosmetic differences were observed between the 2 study groups. A good or excellent symmetry was observed in 59% of irradiated pts and 64% of non irradiated pts. Negative results were observed in 4% and 2%, respectively. Subjective ovulation showed similar results, with a good or excellent symmetry in 57% of irradiated pts and 72.5% of non irradiated pts. Foor results were observed in 16.3% and 27.5%, respectively. Teleangiectasias were observed in 4% of irradiated pts, while hypertrophied scars were only noted in non irradiated pts (15%). No acute side effects of RT, as erythema or ulceration of breast skin, were recorded. Conclusions: In our experience, the standard dose of 50 Gy administered by two opposite tangential fields plus a 10 Gy boost did not affect the cosmetic results of CT-BC, whereas it provided a better local control of disease. The possibility to avoid RT in selected group of pts should be justified by the discomfort of this treatment for the pt, cost analysis and lack of RT centers around the world rather than cosmetic reasons.
|Translated title of the contribution||The effect of radiotherapy on cosmetic outcome of conservative treatment of breast cancer|
|Number of pages||7|
|Publication status||Published - 1994|
- breast cancer
- conservative treatment of breast cancer
- stetical results
ASJC Scopus subject areas