Results of conservative surgery and radiation therapy for breast cancer

Journal Article · Mon Oct 01 04:00:00 EDT 1990 · Surgical Clinics of North America; (USA)

OSTI ID:6069384

Osteen, R T; Smith, B L ^[1]

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1. Harvard Medical School, Boston, MA (USA)

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.

• OSTI ID: 6069384
• Journal Information: Surgical Clinics of North America; (USA), Journal Name: Surgical Clinics of North America; (USA) Vol. 70:5; ISSN 0039-6109; ISSN SCNAA
• Country of Publication: United States
• Language: English

Related Subjects

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550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
DISEASES
DOCUMENT TYPES
GLANDS
LYMPH NODES
LYMPHATIC SYSTEM
MAMMARY GLANDS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOLOGY
RADIOTHERAPY
REVIEWS
SURGERY
THERAPY