The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer

BACKGROUND: Radical or modified radical mastectomy was considered for many years the standard therapy for operable patients. Following radical mastectomy, postoperative irradiation of the chest wall and peripheral lymphatics is indicated in selected highrisk patients. Some studies on breast cancer p...

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Main Authors: Mladenović Jasmina, Borojević Nenad D.
Format: Article
Language:English
Published: Institute of Oncology, Sremska Kamenica, Serbia 2002-01-01
Series:Archive of Oncology
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0354-7310/2002/0354-73100201007M.pdf
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author Mladenović Jasmina
Borojević Nenad D.
author_facet Mladenović Jasmina
Borojević Nenad D.
author_sort Mladenović Jasmina
collection DOAJ
description BACKGROUND: Radical or modified radical mastectomy was considered for many years the standard therapy for operable patients. Following radical mastectomy, postoperative irradiation of the chest wall and peripheral lymphatics is indicated in selected highrisk patients. Some studies on breast cancer patients who underwent radical mastectomy and received adjuvant chemotherapy tried to find out whether the addition of irradiation treatment to the chest wall and regional lymph nodes increases survival. The hypothesis in favor of irradiation is that chemotherapy can eliminate distant micrometastases, but is less effective against local and regional diseases, which are better controlled by radiotherapy. METHODS: In one year period, 110 patients with early stage of breast cancer were treated with radical mastectomy, and postoperative radiotherapy. Forty one patients had only postoperative radiotherapy, 27 received also adjuvant chemotherapy, 40 received adjuvant hormonal therapy and 2 patients received both adjuvant chemo and hormonotherapy. Postoperative irradiation was given on the regional lymph nodes (supra and infraclavicular, axillary and internal mammary nodes) with the tumor dose 48 Gy in 22 fractions over a period of four and a half weeks. All fields were treated with Cobalt 60. RESULTS After the median follow up of 67 months, 33 patients (30 %) had some kind of failure in form of local recurrence, distant metastases or both Locoregional relapse alone or associated with distant metastases occurred in 10 patients (9.1 %). Only 1.8 % of patients had local recurrence as the first failure. Distant metastases occurred in 32 patients (29.1%). After the end of follow up, 60 % patients are alive without evidence of disease while 16.4 % patients are alive with disease. The 5 year overall survival rate was 78.19% and 5 year disease free survival rate was 67.44%. CONCLUSION: Postoperative radiotherapy after radical mastectomy has important role in adjuvant treatment of early breast cancer in combination with adjuvant chemotherapy and hormonotherapy.
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spelling doaj.art-b3ae0fb920ce44d4904ee7e8a5818ea92022-12-22T00:57:06ZengInstitute of Oncology, Sremska Kamenica, SerbiaArchive of Oncology0354-73102002-01-0110171210.2298/AOO0201007MThe role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancerMladenović JasminaBorojević Nenad D.BACKGROUND: Radical or modified radical mastectomy was considered for many years the standard therapy for operable patients. Following radical mastectomy, postoperative irradiation of the chest wall and peripheral lymphatics is indicated in selected highrisk patients. Some studies on breast cancer patients who underwent radical mastectomy and received adjuvant chemotherapy tried to find out whether the addition of irradiation treatment to the chest wall and regional lymph nodes increases survival. The hypothesis in favor of irradiation is that chemotherapy can eliminate distant micrometastases, but is less effective against local and regional diseases, which are better controlled by radiotherapy. METHODS: In one year period, 110 patients with early stage of breast cancer were treated with radical mastectomy, and postoperative radiotherapy. Forty one patients had only postoperative radiotherapy, 27 received also adjuvant chemotherapy, 40 received adjuvant hormonal therapy and 2 patients received both adjuvant chemo and hormonotherapy. Postoperative irradiation was given on the regional lymph nodes (supra and infraclavicular, axillary and internal mammary nodes) with the tumor dose 48 Gy in 22 fractions over a period of four and a half weeks. All fields were treated with Cobalt 60. RESULTS After the median follow up of 67 months, 33 patients (30 %) had some kind of failure in form of local recurrence, distant metastases or both Locoregional relapse alone or associated with distant metastases occurred in 10 patients (9.1 %). Only 1.8 % of patients had local recurrence as the first failure. Distant metastases occurred in 32 patients (29.1%). After the end of follow up, 60 % patients are alive without evidence of disease while 16.4 % patients are alive with disease. The 5 year overall survival rate was 78.19% and 5 year disease free survival rate was 67.44%. CONCLUSION: Postoperative radiotherapy after radical mastectomy has important role in adjuvant treatment of early breast cancer in combination with adjuvant chemotherapy and hormonotherapy.http://www.doiserbia.nb.rs/img/doi/0354-7310/2002/0354-73100201007M.pdfbreast neoplasmsmastectomyradicalradiotherapypostoperative
spellingShingle Mladenović Jasmina
Borojević Nenad D.
The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
Archive of Oncology
breast neoplasms
mastectomy
radical
radiotherapy
postoperative
title The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
title_full The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
title_fullStr The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
title_full_unstemmed The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
title_short The role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
title_sort role of postoperative radiotherapy after radical mastectomy in treatment of early breast cancer
topic breast neoplasms
mastectomy
radical
radiotherapy
postoperative
url http://www.doiserbia.nb.rs/img/doi/0354-7310/2002/0354-73100201007M.pdf
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