This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (19)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Richard A. Steeves, MD, PhD; Pramook Phromratanapongse, MD; William H. Wolberg, MD; Douglass C. Tormey, MD, PhD

Arch Surg. 1989;124(12):1369-1373.

Abstract
•One hundred twenty-two patients (124 tumor sites) with breast carcinoma (T1 to T3, N0 to N2, MO) were treated by a lumpectomy and radiation therapy at the University of Wisconsin, Madison, from June 1978 to December 1986. Irradiation to the breast and regional lymph nodes was carried out with cobalt 60 teletherapy in 2-Gy fractions to 50 Gy, followed by an additional boost of 10 Gy to the tumorectomy site with coned electrons. Cosmesis was analyzed by scoring the effects of surgery, as well as the effects of irradiation, and by photographic assessment. After a follow-up of 24 to 119 months (median, 36 months), 82% of the patients were found to have good or excellent cosmetic scores. There was a trend that favored better cosmetic results in younger patients and in patients with outer-quadrant lesions. No significant impact of adjuvant chemotherapy on the cosmetic outcome or on the complications of treatment was demonstrated. There were six local recurrences (5.2%), three of which were true recurrences and the other three that were new primary tumors; 11 distant failures (9%) occurred. The following side effects from irradiation developed in only 5 patients (4.1%): match-line fibrosis (n=2), soft-tissue necrosis (n=1), and persistent tenderness (n = 2). The conditions of the two patients with persistent tenderness responded favorably with conservative management. We concluded that a lumpectomy, followed by radiation therapy, provides good cosmetic results without compromising the local control rate. If adjuvant chemotherapy is planned, we recommend that it be administered before radiation therapy in favor of concomitant therapy with both modalities.

(Arch Surg. 1989;124:1369-1373)

Author Affiliations
From the Department of Human Oncology, University of Wisconsin, Madison.

Footnotes
Accepted for publication July 1, 1989.

Reprint requests to Division of Radiation Oncology, University of Wisconsin, 600 Highland Ave, Madison, WI53792 (Dr Steeves).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cosmetic Outcome in Patients Receiving an Interstitial Implant as Part of Breast-Conservation Therapy
Kramer et al.
Radiology 1999;213:61-66.
ABSTRACT | FULL TEXT  

Effect of Different Combinations of Dietary Additives on Bacterial Translocation and Survival in Gut-Derived Sepsis
Gennari et al.
JPEN J Parenter Enteral Nutr 1995;19:319-325.
ABSTRACT  

Oral Glutamine Decreases Bacterial Translocation and Improves Survival in Experimental Gut-Origin Sepsis
Gianotti et al.
JPEN J Parenter Enteral Nutr 1995;19:69-74.
ABSTRACT