Prognostic factors for recurrence and cosmesis in 393 patients after radiation therapy for early mammary carcinoma

Journal Article · Tue Aug 01 04:00:00 EDT 1989 · Radiology; (United States)

DOI:https://doi.org/10.1148/radiology.172.2.2546175· OSTI ID:5816338

Ryoo, M C; Kagan, A R; Wollin, M; Tome, M A; Tedeschi, M A; Rao, A R; Hintz, B L; Kuruvilla, A M; Nussbaum, H; Streeter, Jr, O E

Between 1978 and 1985, 393 of 2,765 (14%) patients with operable cancer of the breast (clinical stage T0-3N0-2M0) were irradiated after excisional biopsy and staging axillary dissection. Of 77 patients with microscopic axillary metastases, 68 received systemic adjuvant therapy. Treatment failed locally in 26 cases, and there were seven patients with distant metastasis. The three major factors for increased local treatment failure were (a) age below 40 years (P = .003), (b) negative estrogen receptor assay result (P = .03), and (c) failure to deliver a radiation boost dose when tumor was present at the margin of the specimen (P = .002). The size of the tumor, the nodal status, the progesterone receptor assay result, and the presence of ductal carcinoma in situ mixed with infiltrating carcinoma did not show a significant influence on local recurrence. In 274 of 393 (70%) patients, cosmesis was evaluated. The four major factors affecting cosmesis favorably were (a) utilization of a wedge (P less than .0001); (b) treatment of two fields a day (P less than .0001); (c) failure to use a separate treatment port to the regional lymph nodes, so as to avoid field junctions (P = .0003); and (d) small size of specimen (less than 50 cm2) (P = .0171). A second or third cancer was found in 39 of the 393 (10%) patients; contralateral breast cancer was the most common form (n = 23), followed by genitourinary cancer (n = 5). The most frequent complication was arm edema (6%).

• Research Organization: Southern California Permanente Medical Group, Los Angeles (USA)
• OSTI ID: 5816338
• Journal Information: Radiology; (United States), Journal Name: Radiology; (United States) Vol. 172:2; ISSN RADLA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
560151 -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BODY
CARCINOMAS
DISEASES
DOSES
GLANDS
IRRADIATION PROCEDURES
MAMMARY GLANDS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SURVIVAL CURVES
THERAPY