Breast carcinoma treated by conservative surgery - Results of postoperative external radiotherapy with photons only and a nonsplit supraclavicular field

Eighty-nine breasts in 85 patients were treated by lumpectomy and then radi otherapy from a Co-60 source only. The supraclavicular field was nonsplit. Eighty percent were in their 40s, 60s, or 70s with almost equal distributio n. The majority of cases (80%) was T1 followed by T2 (18%). Axillary dissec tion was not done in 26% of patients. The majority (84%) had infiltrating d uctal carcinoma; 6% had carcinoma in situ only. The dose to the boast inclu ding the boost was in the range of 6,000 cGy to 7,000 cGy in 96%, whereas i n 4% it was in the range of 5,000 cGy. Forty-four patients (49%) with NO di d not have nodal irradiation. The dose to the nodes in the remaining patien ts ranged from 5,040 to 6,840 cGy. The cosmetic result was good to excellen t in 99% of evaluated patients. There was telangiectasia in 1, arm edema in 2, no fibrosis in supraclavicular-tangential fields junction and no other soft-tissue or bone complications. Fifteen percent died; 6% had no evidence of cancer, and 9% had metastatic disease. Two had local recurrence, but wi th salvage mastectomy and systemic therapy were alive and well. The use of external photons only for breast irradiation and a nonspilt supraclavicular field yielded good results compared with alternative methods.