Breast‐conserving surgery with radiation therapy for operable mammary carcinoma: A 25‐year experience

Abstract

Abstract This article describes the long‐term results of breast‐conserving treatment for 1,133 consecutive patients with operable mammary cancer treated from 1961 to 1979 by limited surgery followed by curative irradiation. Follow‐up ranged from 5 to 23 years. The percentage of patients (clinical stages I and II combined) alive and well at 5, 10, and 15 years was 86%, 80%, and 62%, respectively. The percentage of cured patients having retained their treated breast was 85% at 15 years. One hundred forty‐nine patients (13.2%) developed recurrence in the treated breast and 67 patients (5.9%) recurred in the axilla, most commonly in conjunction with breast failure. Ninety‐one percent of the local‐regional recurrences were operable, and the 5‐year survival following salvage surgery was 61%. The cosmetic results of therapy were judged to be good or excellent in 70% of patients at 15 years, with 2–4% of the patients having unacceptable results. It is concluded that breast‐conserving surgery followed by radiation therapy for clinical stages I and II results in survival rates equivalent to those achieved by primary radical surgery. This method allows reliable local‐regional disease control while permitting the majority of patients to retain their breasts in an esthetically acceptable condition. In contrast to recurrences after radical surgery, local‐regional recurrences after conservative therapy can be successfully treated by further surgery .