DOES CONCOMITANT CHEMORADIOTHERAPY INFLUENCE COSMETIC OUTCOME IN CONSERVATIVE TREATMENT OF BREAST-CANCER

Purpose: To evaluate retrospectively factors influencing the cosmetic outcome after conservative treatment for breast cancer. Material and m ethods: From 1988 until 1992, 164 patients were treated with conservat ive surgery (quadrantectomy) and radiotherapy with Co-60 (50 Gy On the whole breast) plus 10 Gy on the surgical bed (300 kV photons) for T1- T2 breast cancers; 46 patients (28%) received concomitant adjuvant che motherapy (CMF schedule). Cosmesis evaluation was carried out after 24 to 108 months (median, 38 months). A logistic regression analysis was performed to identify independent variables influencing the aesthetic outcome. P values of 0.05 or less were considered significant. Result s: Univariate analysis showed that T2 versus T1 (P = 0.0102), lower qu adrants site (P = 0.0002) and concomitant adjuvant chemotherapy (P = 0 .0009) produced a worse aesthetic outcome. Multivariate analysis confi rmed the same factors: tumor size (P = 0.0020), tumor site (P = 0.0150 ) and concomitant chemotherapy (P = 0.0024). Conclusions: The signific ant negative influence on the cosmetic outcome of concomitant adjuvant chemotherapy implies questions about the timing of radiotherapy and c hemotherapy in breast cancer conservative treatment.