skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Results of conservative surgery and radiation therapy for breast cancer

Abstract

For stage I or II breast cancer, conservative surgery and radiation therapy are as effective as modified radical or radical mastectomy. In most cases, cosmetic considerations and the availability of therapy are the primary concerns. The extent of a surgical resection less than a mastectomy has not been a subject of a randomized trial and is controversial. It appears that removal of a quadrant of the breast for small lesions is safe but excessive. It may be possible to limit the breast resection to gross tumor removal for most patients while using wider resections for patients with an extensive intraductal component or for invasive lobular carcinoma. It also appears that excluding patients from breast conservation on the basis of positive margins on the first attempt at tumor excision may be unnecessarily restrictive. Although patients with an extensive intraductal component or invasive lobular carcinoma should have negative margins, it appears that a patient with predominantly invasive ductal carcinoma can be treated without re-excision if all gross tumor has been resected and there is no reason to suspect extensive microscopic disease. Patients with indeterminate margins should have a re-excision. Axillary dissection provides prognostic information and prevents progression of the disease within themore » axilla. Axillary dissections limited to level I will accurately identify a substantial number of patients who have pathologically positive but clinically negative nodes. When combined with radiation therapy to the axilla, a level I dissection results in a limited number of patients with progressive axillary disease. Patients with pathologically positive axillas and patients at particularly high risk for systemic disease because of the extent of axillary node involvement can be identified by dissections of levels I and II. 60 references.« less

Authors:
;  [1]
  1. Harvard Medical School, Boston, MA (USA)
Publication Date:
OSTI Identifier:
6069384
Resource Type:
Journal Article
Journal Name:
Surgical Clinics of North America; (USA)
Additional Journal Information:
Journal Volume: 70:5; Journal ID: ISSN 0039-6109
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; RADIOTHERAPY; MAMMARY GLANDS; LYMPH NODES; PATIENTS; REVIEWS; SURGERY; BODY; DISEASES; DOCUMENT TYPES; GLANDS; LYMPHATIC SYSTEM; MEDICINE; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; THERAPY; 550603* - Medicine- External Radiation in Therapy- (1980-); 550600 - Medicine

Citation Formats

Osteen, R T, and Smith, B L. Results of conservative surgery and radiation therapy for breast cancer. United States: N. p., 1990. Web.
Osteen, R T, & Smith, B L. Results of conservative surgery and radiation therapy for breast cancer. United States.
Osteen, R T, and Smith, B L. 1990. "Results of conservative surgery and radiation therapy for breast cancer". United States.
@article{osti_6069384,
title = {Results of conservative surgery and radiation therapy for breast cancer},
author = {Osteen, R T and Smith, B L},
abstractNote = {For stage I or II breast cancer, conservative surgery and radiation therapy are as effective as modified radical or radical mastectomy. In most cases, cosmetic considerations and the availability of therapy are the primary concerns. The extent of a surgical resection less than a mastectomy has not been a subject of a randomized trial and is controversial. It appears that removal of a quadrant of the breast for small lesions is safe but excessive. It may be possible to limit the breast resection to gross tumor removal for most patients while using wider resections for patients with an extensive intraductal component or for invasive lobular carcinoma. It also appears that excluding patients from breast conservation on the basis of positive margins on the first attempt at tumor excision may be unnecessarily restrictive. Although patients with an extensive intraductal component or invasive lobular carcinoma should have negative margins, it appears that a patient with predominantly invasive ductal carcinoma can be treated without re-excision if all gross tumor has been resected and there is no reason to suspect extensive microscopic disease. Patients with indeterminate margins should have a re-excision. Axillary dissection provides prognostic information and prevents progression of the disease within the axilla. Axillary dissections limited to level I will accurately identify a substantial number of patients who have pathologically positive but clinically negative nodes. When combined with radiation therapy to the axilla, a level I dissection results in a limited number of patients with progressive axillary disease. Patients with pathologically positive axillas and patients at particularly high risk for systemic disease because of the extent of axillary node involvement can be identified by dissections of levels I and II. 60 references.},
doi = {},
url = {https://www.osti.gov/biblio/6069384}, journal = {Surgical Clinics of North America; (USA)},
issn = {0039-6109},
number = ,
volume = 70:5,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 1990},
month = {Mon Oct 01 00:00:00 EDT 1990}
}