Long term results of conservative management in T1 and T2 breast cancer among 170 cases

ABSTRACT

This retrospective study included 170 patients with histologically proven early breast carcinoma [T1 and T2 /<4 cm]. All patients underwent a conservative surgical resection of the primary tumor and axillary dissection. Postoperative radiation therapy was given as whole breast irradiation to a total dose of 50 Gy over 5 weeks in 25 fractions, followed by a boost 16 Gy over 1 and 1/2 weeks in 8 fractions to the tumor bed. Among the whole group, only 122 patients received adjuvant chemotherapy. At the end of the study with a median follow up period of 60 months, treatment failure was documented in 70 patients. Isolated local recurrence was detected in 26 patients and regional recurrence was reported in only 4 patients. Distant dissemination was recorded in 40 patients. Univariate analysis revealed that age group, menopausal status and adjuvant chemotherapy were significant factors influencing the relapse rate [0.006, 0.006 and 0.032, respectively]. The overall actuarial 5- and 10-year survival rates for the whole group were 80% and 60%, respectively. The overall actuarial 5 and 10-year survivals for patients developing local recurrence were significantly higher than the survival of patients who developed regional or distant relapse denoting a successful salvage treatment. While, the 5- and 10-year distant metastasis free survival rates of the whole group were 64.5% and 49.2%, respectively. Cox regression multivariate analysis showed that the relapse site, adjuvant chemotherapy, age group and number of involved axillary lymph nodes were independent prognostic factors that significantly influenced the over survival. On the other hand, the relapse site and age group were the significant factors that affected the distant metastasis free survival