ABSTRACT

In the present study treatment results and the prognostic factors influencing survival and local control rates after breast conserving surgery and radiotherapy were evaluated.

Three hundred sixty five patients treated with radiotherapy after breast conserving surgery during 1990-2002 were evaluated retrospectively. Radiotherapy dose was 50 Gy for the whole breast and 10-20 Gy boost for the tumor bed. Median total dose was 60 Gy (range 50-74) with a daily fraction dose of 2 Gy.

One hundred sixty-six patients (45.4%) had Stage I, 180 (49.3%) had Stage IIA, 19 (5.2%) had Stage IIB disease. Axillary sampling or dissection was performed in 347 patients with a median of 13 lymph nodes (range 1-44) dissected. Median age was 47 (range: 19-80). The most common histologic type was invasive ductal carcinoma (66%). During a median follow-up duration of 68 months (range: 5-185) 21 patients (5.8%) developed local recurrence and 33 patients (9.0%) developed distant metastasis and 25 patients (6.8%) had died due to breast cancer. Five-year overall, disease-free survival and local control rates were 92.1%, 88.4% and 93.7% respectively. The only prognostic factor influencing overall survival was estrogene receptor (ER) negativity (p=0.05). The factors affecting local control were (+) surgical margins (p=0.01), operation-radiotherapy interval more than 60 days (p=0.02). In multivariate analysis lymph node metastasis (p=0.05) and ER negativity (p=0.03) were the prognostic factors influencing disease-free survival.

In the present study ER status, surgical margins, lymph node metastasis and starting radiotherapy late were the significant prognostic factors.