LONG-TERM RESULTS WITH BREAST-CONSERVING THERAPY FOR PATIENTS WITH EARLY-STAGE BREAST-CARCINOMA IN A COMMUNITY-HOSPITAL SETTING

BACKGROUND. Prospective randomized trials and retrospective reviews fr om academic centers have documented the success of breast-conserving t herapy (BCT) for patients with early stage breast carcinoma. The autho rs retrospectively reviewed the outcome of BCT for early stage breast carcinoma to determine the success of BCT at the study institution, a 1000-bed community hospital. METHODS. Between January 1980 and Decembe r 1987, 400 cases of Stage I and II breast carcinoma were managed with BCT at the study institution. All patients were treated with an excis ional biopsy. The axilla was surgically staged in 383 patients (96%). Postoperative treatment was composed of 45-50 gray (Gy) external beam irradiation to the whole breast and a boost to the tumor bed to at lea st 60 Gy in all patients. The median follow-up of the 292 surviving pa tients is 118 months. RESULTS. At last follow-up, there were 37 local recurrences for 5- and 10-year actuarial rates of 4% and 10%, respecti vely. Clinical, pathologic, and treatment-related factors were analyze d for an association with local recurrence. On univariate analysis, pa tient age less than or equal to 35 years and positive surgical margins were associated with an increased risk of local recurrence. On multiv ariate analysis, only patient age less than or equal to 35 years remai ned significant. The 10-year actuarial regional recurrence rate was 5% . The 10-year actuarial cause specific survival rate was 91% and 69% f or Stage I and II patients, respectively. CONCLUSIONS. BCT for patient s with early stage breast carcinoma in a community hospital setting pr oduces excellent results comparable to contemporary series reported fr om academic institutions and multiinstitution trials. (C) 1998 America n Cancer Society.