Results of treating stage iii carcinoma of the breast by primary radiation therapy

Abstract

One hundred sixteen patients with stage 111 carcinoma of the breast were treated by primary radiation therapy. The 5-year actuarial survival and relapsefree survival were 25% and 2296, respectively. The 5-year actuarial probability of local tumor control for the entire group was 64%. In patients undergoing an excisional biopsy and an interstitial implant of the primary tumor area, local control was 100%. In patients who had either an excisional biopsy or an implant, the 5-year actuarial probability of local control was 77% and 76%, respectively. In contrast, in patients having neither an excisional biopsy nor an implant, local control was only 41 %. In patients receiving a total dose of greater than 6000 rad, from external beam treatment or from external beam plus an interstitial implant, the local control was 78% compared to 39% in patients receiving a total dose of less than 6000 rad. Forty-one patients received some form of adjuvant therapy. Both local control and relapse-free survival were improved in patients receiving chemotherapy as the sole adjuvant and in patients receiving chemotherapy combined with an endocrine ablative procedure. However, patients treated with only an endocrine ablative procedure had no improvement in survival nor in local control. These results indicate that primary radiation therapy can provide local control in a high proportion of patients with stage I11 carcinoma of the breast and suggest that chemotherapy is effective in improving both local control and survival in these patients.Cancer 43:985-993, 1979.ATIENTS WITH stage I11 carcinoma of the P breast often present with advanced local disease that is difficult to control. Even if local control is obtained, the majority of patients develop distant metastases. Therefore, successful treatment for this stage of breast cancer must contain both local and systemic therapies. Attempts at employing radical surgery in this setting have not been successful. In 1943, Haagensen and Stout21 established operability guidelines based on their observations that certain grave signs heralded poor results when patients were treated by radical surgery. In 120 cases, retrospectively classified as inoperable by their criteria, the local recurrence rate was 49.2%; and only one pa-

T3b-T4 breast cancer: factors affecting results in combined modality treatments

“…These dismal results were translated into a very poor survival rate since only 19"7 per cent of women remained alive 5 years after beginning of treatment. Apparently, these results seem to be even worse than those reported in published series where optimal primary radiotherapy alone was administered [4,9,10,20]. However, interstudy comparisons among published series and the present series should be carried out with great caution.…”

The role of radiotherapy in the management of operable locally advanced breast carcinoma

“…Patients were vival was not improved in those cases. 5,6 The necessity of attacking occult distant metastases became obvious required to have undergone a modified or standard radical mastectomy with grossly tumor-free margins as early studies reported substantial gains in both local control and disease free survival when chemotherapy that left them with no evidence of disease (NED) less than 6 weeks prior to study entry. The removal and was combined with surgery and/or radiation in the management of both operable and nonresectable examination of at least eight ipsilateral axillary lymph nodes and an estrogen receptor analysis on the pri-LABC.…”

“…The removal and was combined with surgery and/or radiation in the management of both operable and nonresectable examination of at least eight ipsilateral axillary lymph nodes and an estrogen receptor analysis on the pri-LABC. 6,7,8 Based on this background, this Eastern Cooperative Oncology Group (ECOG) trial was conceived mary tumor were required. Other eligibility criteria included an ECOG performance status of 0, 1, or 2; a and designed with the following assumptions: (1) The management of LABC must be multimodal, and subwhite blood count equal to or greater than 4,000/mm 3 ; platelet count equal to or greater than 100,000/mm; stantial progress in its management is dependent on the development and use of effective systemic therapy creatinine less than or equal to 1.5 mg%; normal blood urea nitrogen; normal serum glutamic -oxaloacetic integrated with surgery and irradiation as locoregional treatments.…”

Locoregional Outcomes of Inflammatory Breast Cancer Patients Treated With Standard Fractionation Radiation and Daily Skin Bolus in the Taxane Era

“…The condition of IBC exhibits a tendency for early recurrence (3) and inferior prognosis (4,5). Historically, outcomes with radiation and surgery alone were poor (6). Since the incorporation of neoadjuvant (NA) chemotherapy into treatment over the past several decades, a significant proportion of patients have demonstrated long-term survival (7).…”