Local tumor control and cosmetic outcome following breast-conserving surgery and radiation up to a total dose of 56 Gy without boost in breast cancerpatients

Purpose: To evaluate overall survival, local tumor control and cosmetic out come after breast-conserving surgery followed by radiotherapy without, boos t irradiation. Patients end Methods: In a retrospective study 270 breast cancer patients w ere treated with breast conserving surgery combined with a homogenous radia tion of the tumor bearing breast up to a total dose of 56 Gy without Local boost irradiation. Mean follow-up was 48 months. Local tumor control, side effects, cosmetic results and contentment with treatment were assessed usin g physical examinations and interviews based on a standardized questionnair e. Results: Cause-specific survival at 5 years after treatment was 88.3%, actu arial disease-free survival at 5 years was 76.1%. Within 23 to 78 months af ter treatment 12 patients suffered from ipsilateral breast recurrence. The actuarial freedom from local recurrence (single tumor manifestation) was 96 .8% at 5 years after treatment, 89% at 10 years. The occurrence of Local fa ilures was not significantly correlated to tumor size, margins, grading, no dal status, age or lymphangiosis. 15.6% of the patients developed distant m etastases. In all patients treatment was performed without interruption. Si de effects were predominantly of mild degree, no severe side effects were d etected. 73% of physicians and 81% of patients scored their cosmetic outcom e as excellent or good. 93% of patients would again decide in favor of this procedure. Whereas use of adjuvant chemotherapy as well as subcutaneous re construction of breast tissue did not significantly affect breast cosmesis, analysis demonstrated impaired cosmetic results related to a Larger breast size. Conclusion: The data of this study show that tumor control achieved by brea st conserving surgery in combination with a radiation technique up to a tot al dose of 56 Gy which omits boost irradiation is within the range of Liter ature data. Side effects of the therapy were tolerable. The treatment displ ayed a good compatibility with tolerable side effects and good cosmetic res ults.