Abstract
Purpose: Over the past several years, it has been our standard policy after breast conserving surgery to treat the entire breast to 45-50 Gy followed by a supplemental boost dose to the tumor bed to a minimum of 60 Gy with standard fractionation. We reviewed patients who received < 60 Gy to the tumor bed to identify any differences in recurrence rates in the breast. Materials and Methods: From 1/1/75 through 12/31/87, 443 consecutive patients diagnosed with stage I and II breast cancer (unilateral) were treated with conservative surgery and radiation therapy (CSRT) at William Beaumont Hospital. All patients underwent at least an excisional biopsy and 268 (60%) patients were re-excised. An ipsilateral axillary lymph node dissection was performed on 420 patients (95%). All patients received whole breast irradiation to 45-50 Gy. A supplemental boost dose was delivered to the tumor bed with either an implant, electrons, or photons in 404 (91%) patients. Median follow-up of surviving patients is 88 months. Results: Thirty-three patients of the 443 have suffered a failure in the treated breast for a 5 and 10 yr actuarial rate of local recurrence of 5 and 10%, respectively. Evaluation by total dose to the tumor bed is
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Citation Formats
White, Julia, Brown, Douglas, Gustafson, Greg, Chen, Peter, Matter, Richard, Cook, Carla, Martinez, Alvaro, and Vicini, Frank A.
The role of total dose in conservative surgery and radiation therapy for early stage breast cancer: is there a critical level?.
United States: N. p.,
1995.
Web.
doi:10.1016/0360-3016(95)97894-7.
White, Julia, Brown, Douglas, Gustafson, Greg, Chen, Peter, Matter, Richard, Cook, Carla, Martinez, Alvaro, & Vicini, Frank A.
The role of total dose in conservative surgery and radiation therapy for early stage breast cancer: is there a critical level?.
United States.
https://doi.org/10.1016/0360-3016(95)97894-7
White, Julia, Brown, Douglas, Gustafson, Greg, Chen, Peter, Matter, Richard, Cook, Carla, Martinez, Alvaro, and Vicini, Frank A.
1995.
"The role of total dose in conservative surgery and radiation therapy for early stage breast cancer: is there a critical level?"
United States.
https://doi.org/10.1016/0360-3016(95)97894-7.
@misc{etde_20420745,
title = {The role of total dose in conservative surgery and radiation therapy for early stage breast cancer: is there a critical level?}
author = {White, Julia, Brown, Douglas, Gustafson, Greg, Chen, Peter, Matter, Richard, Cook, Carla, Martinez, Alvaro, and Vicini, Frank A}
abstractNote = {Purpose: Over the past several years, it has been our standard policy after breast conserving surgery to treat the entire breast to 45-50 Gy followed by a supplemental boost dose to the tumor bed to a minimum of 60 Gy with standard fractionation. We reviewed patients who received < 60 Gy to the tumor bed to identify any differences in recurrence rates in the breast. Materials and Methods: From 1/1/75 through 12/31/87, 443 consecutive patients diagnosed with stage I and II breast cancer (unilateral) were treated with conservative surgery and radiation therapy (CSRT) at William Beaumont Hospital. All patients underwent at least an excisional biopsy and 268 (60%) patients were re-excised. An ipsilateral axillary lymph node dissection was performed on 420 patients (95%). All patients received whole breast irradiation to 45-50 Gy. A supplemental boost dose was delivered to the tumor bed with either an implant, electrons, or photons in 404 (91%) patients. Median follow-up of surviving patients is 88 months. Results: Thirty-three patients of the 443 have suffered a failure in the treated breast for a 5 and 10 yr actuarial rate of local recurrence of 5 and 10%, respectively. Evaluation by total dose to the tumor bed is as follows: The distribution of patient's respective histology, tumor size, hormonal status, age, re-excision status, and adjuvant systemic therapy was similar among the dose groups. On multivariate analysis (Cox), in addition to total dose to tumor bed (p=0.002), the only other factor which was significantly associated with local recurrence was patient age {<=} 35 (p=0.002). Conclusions: Patients who receive {<=} 50 Gy to the tumor bed without careful attention to excisional status are at a significantly higher risk of local failure. This underlies the importance of supplementing the tumor bed dose after whole breast radiation therapy in those patients whose status of excision is not definitely known.}
doi = {10.1016/0360-3016(95)97894-7}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}
title = {The role of total dose in conservative surgery and radiation therapy for early stage breast cancer: is there a critical level?}
author = {White, Julia, Brown, Douglas, Gustafson, Greg, Chen, Peter, Matter, Richard, Cook, Carla, Martinez, Alvaro, and Vicini, Frank A}
abstractNote = {Purpose: Over the past several years, it has been our standard policy after breast conserving surgery to treat the entire breast to 45-50 Gy followed by a supplemental boost dose to the tumor bed to a minimum of 60 Gy with standard fractionation. We reviewed patients who received < 60 Gy to the tumor bed to identify any differences in recurrence rates in the breast. Materials and Methods: From 1/1/75 through 12/31/87, 443 consecutive patients diagnosed with stage I and II breast cancer (unilateral) were treated with conservative surgery and radiation therapy (CSRT) at William Beaumont Hospital. All patients underwent at least an excisional biopsy and 268 (60%) patients were re-excised. An ipsilateral axillary lymph node dissection was performed on 420 patients (95%). All patients received whole breast irradiation to 45-50 Gy. A supplemental boost dose was delivered to the tumor bed with either an implant, electrons, or photons in 404 (91%) patients. Median follow-up of surviving patients is 88 months. Results: Thirty-three patients of the 443 have suffered a failure in the treated breast for a 5 and 10 yr actuarial rate of local recurrence of 5 and 10%, respectively. Evaluation by total dose to the tumor bed is as follows: The distribution of patient's respective histology, tumor size, hormonal status, age, re-excision status, and adjuvant systemic therapy was similar among the dose groups. On multivariate analysis (Cox), in addition to total dose to tumor bed (p=0.002), the only other factor which was significantly associated with local recurrence was patient age {<=} 35 (p=0.002). Conclusions: Patients who receive {<=} 50 Gy to the tumor bed without careful attention to excisional status are at a significantly higher risk of local failure. This underlies the importance of supplementing the tumor bed dose after whole breast radiation therapy in those patients whose status of excision is not definitely known.}
doi = {10.1016/0360-3016(95)97894-7}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}