RADIOTHERAPY AFTER BREAST-PRESERVING SURGERY IN WOMEN WITH LOCALIZED CANCER OF THE BREAST

Background and Methods. Conservative surgery and radiotherapy have bec ome well-established treatments for breast cancer, and many trials in progress are attempting to define the most acceptable type of procedur e. Between 1987 and 1989 we randomly assigned 567 women with small bre ast cancers (<2.5 cm in diameter) to quadrantectomy followed by radiot herapy or to quadrantectomy without radiotherapy. All patients underwe nt total axillary dissection. The median follow-up period was 39 month s (range, 28 to 54). Results. The incidence of local recurrence was 8. 8 percent among the patients treated with quadrantectomy without radio therapy, as compared with 0.3 percent among those treated with postsur gical radiotherapy (P = 0.001). However, there was a substantial effec t of age: patients more than 55 years old who did not receive radiothe rapy had a low rate of local recurrence (3.8 percent). The four-year o verall survival was similar in the two treatment groups. Conclusions. Administering radiotherapy after quadrantectomy reduces the risk of lo cal recurrence in women with small cancers of the breast, but radiothe rapy may not be necessary in elderly women.