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The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

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Abstract

Background

Treatment outcome was evaluated in patients who underwent breast-conserving therapy and tangential irradiation. After verifying background factors including systemic therapy, the clinical efficacy of postoperative irradiation was investigated.

Method

There were 708 study subjects, all of whom had early breast cancer treated between 1992 and 2002. The median follow-up period was 83 months. After breast-conserving surgery, in patients with negative surgical margins, only tangential irradiation at 48 Gy/24 fr was performed. In contrast, in those with positive surgical margins, 10 Gy of radiation boost to the tumor bed with electrons was administered after tangential irradiation with 50 Gy/25 fr. Treatment outcome was analyzed using the Kaplan–Meier method and Cox’s proportional hazards regression model.

Results

The disease-free survival and no-recurrence rates within the ipsilateral breast after 5 years were 93.4 and 97.2%, respectively. Risk factors for recurrence within the ipsilateral breast included younger age of patient, the number of positive lymph nodes, and no endocrine therapy. However, the surgical margin was not a risk factor. Risk factors for relapse outwith the ipsilateral breast included younger age, the number of positive lymph nodes, and recurrence within the ipsilateral breast.

Conclusions

From our analysis of 708 Japanese women who received breast-conserving therapy, which can be regarded as a standard method in Japan, the treatment outcome was compatible with previous reports from other countries.

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Abbreviations

NRRB:

No recurrence rate within ipsilateral breast

DFSR:

Disease-free survival rate

y.o:

Years old

fr:

Fraction

Tm:

Tumorectomy

Bp:

Wide excision

Bq:

Quadrantectomy

RTP:

Radiation treatment planning device

SC-irradiation:

Irradiation to the ipsilateral supraclavicular nodal region

ER:

Estrogen receptor

PgR:

Progesterone receptor

K–M method:

The Kaplan–Meier method

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Acknowledgments

We thank Fumio Sakauchi MD. Ph.D. (Department of Public Health, Sapporo Medical University School of Medicine) for advice on statistical analysis.

Author information

Authors and Affiliations

  1. Department of Radiology, Teine Keijinkai Hospital, 1-40, 12-choume, 1-jou, Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan

    Atsushi Oouchi

  2. Department of Radiology, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan

    Atsushi Oouchi, Koh-ichi Sakata, Mitsuharu Tamakawa, Masanori Someya, Kensei Nakata, Masato Hareyama, Masakazu Hori & Taishi Satoh

  3. Sapporo Kotoni Nyuusen Clinic, Sapporo, Hokkaido, Japan

    Hideji Masuoka, Kazuaki Asaishi & Izuru Shimokawara

  4. Department of Radiology, KKR Sapporo Medical Center, Sapporo, Hokkaido, Japan

    Hisayasu Nagakura

  5. Sapporo Nyuusen Geka Clinic, Sapporo, Hokkaido, Japan

    Minoru Okazaki, Akira Okazaki & Yoshiki Watanabe

  6. Shinsapporo Nyuusen Clinic, Sapporo, Hokkaido, Japan

    Yutaka Okazaki, Tsuyoshi Yamada & Tomokazu Yuyama

  7. First Department of Surgery, Sapporo Medical University, School of Medicine, Sapporo, Hokkaido, Japan

    Tousei Ohmura & Koichi Hirata

Authors
  1. Atsushi Oouchi
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  2. Koh-ichi Sakata
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  3. Hideji Masuoka
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  4. Mitsuharu Tamakawa
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  5. Hisayasu Nagakura
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  6. Masanori Someya
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  8. Kazuaki Asaishi
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  9. Minoru Okazaki
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  10. Yutaka Okazaki
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  12. Masato Hareyama
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  13. Masakazu Hori
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  14. Izuru Shimokawara
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  15. Akira Okazaki
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  16. Yoshiki Watanabe
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  17. Tsuyoshi Yamada
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  18. Tomokazu Yuyama
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  19. Taishi Satoh
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  20. Koichi Hirata
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Corresponding author

Correspondence to Atsushi Oouchi.

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Oouchi, A., Sakata, Ki., Masuoka, H. et al. The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy. Breast Cancer 16, 49–57 (2009). https://doi.org/10.1007/s12282-008-0079-3

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  • DOI: https://doi.org/10.1007/s12282-008-0079-3

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