Postoperative radiation therapy for carcinoma of the breast: improved results with elective irradiation of the chest wall

Journal Article · Tue Jun 01 00:00:00 EDT 1982 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(82)90164-X· OSTI ID:6724495

Toonkel, L M; Fix, I; Jacobson, L H; Schneider, J J; Wallach, C B

A review was conducted of all patients wth primary cancer of the breast treated by the Radiation Therapy Department of Mount Sinai Medical Center from 1966-1978. The initial surgical procedure was radical mastectomy or modified radical mastectomy for 926 patients. The mean follow-up for this group was 6.42 years; the range was 1-13 years. All postoperative therapy was given with megavoltage equipment. Treatment was directed to either the peripheral lymphatics (internal mammary chain, supraclavicular and axillary apex) or to the peripheral lymphatics fossa and chest wall.The decision to include the chest wall within the treatment volume was based upon the extent of disease at the primary site and the degree of involvement of the axilla. Curves were generated to compare, by stage, control of disease for both postoperative radiotherapy techniques. The expected enhancement of local (regional) control was seen for patients with more advanced disease who received chest wall irradiation. Differences favoring the more comprehensively irradiated group were also seen in disease-free and overall survival for all three stages of disease, with statistically significant benefit in survival analysis for patients with Stage II and III disease.(Stage II - peripheral lymphatic group: 5 year = 54%; 10 years = 36%. Peripheral lymphatic plus chest wall group: 5 years = 71%; 10 years = 49%. Stage III - peripheral lymphatic group: 5 year = 32%; 10 years = 15%. Peripheral lymphatic plus chest wall group: 5 year = 51%; 10 year = 38%.) These results imply that microscopic residual disease within the soft tissues of the chest wall can metastasize without necessarily manifesting as regionally recurrent disease.

• Research Organization: Mount Sinai Medical Center, Miami Beach, FL
• OSTI ID: 6724495
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Vol. 8:6
• Country of Publication: United States
• Language: English

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