A shorter fractionation schedule for postlumpectomy breast cancer patients

Purpose: The purpose of this retrospective review was to determine the effe ctiveness of 40 Gy in 16 daily fractions in preventing local recurrence in postlumpectomy invasive breast cancer patients whose margins of resection w ere clear of tumor by at least 2 mm. Methods: Between September 1989 and December 1993, 294 breasts were treated with this regimen. The entire breast was treated, using a tangential paral lel pair, with wedges as necessary, to a dose of 40 GS in 16 daily fraction s. No additional boost was given. The median duration of follow-up of survi ving patients is 5.5 years. Recently, the patients' assessment of the cosme tic outcome of their treatment was obtained, using a mailed questionnaire. Results: The 5-year actuarial breast-relapse rate was 3.5%, with an overall 5-year survival and disease-specific survival of 87.8% and 92.1%, respecti vely. In response to the cosmesis questionnaire, 77% of patients stated the y were either extremely or very satisfied with the overall appearance of th e breast, 19.5% moderately satisfied, and 3.5% either slightly or not at al l satisfied. The corresponding responses for overall level of comfort of th e breast were 79%, 16.5%, and 4.5% respectively. Conclusion: This regimen is very effective at preventing recurrent breast c ancer in this group of patients, and it provides a high level of patient sa tisfaction with cosmetic outcome. Its short duration offers the added advan tage of a more efficient use of resources and greater patient convenience. (C) 2000 Elsevier Science Inc.