The Related Study Of Breast-conserving Surgery Plus Postoperative Tangential Irradiation

Objective To observe the efficacy in some early breast cancer patients received breast-conserving treatment in our hospital ,and we use a study to compare the term efficacy,side-effect,recurrence rate,transfer rate and survival rate of breast conservation therapy(BCT) with modified radical mastectomy (MRM) in women with early stage breast cancer.Methods A matched study using data on Patients of breast cancer data base was conducted. the data base included Patients who received MRM or BCT from 2005 to 2010 in our hospital. the match was conducted according to eight variables: tumor size, location, pathological type, axillary lymph node status, estrogen and progesterone receptor level, neoadjuvant therapy cases, HER-2 protein expression level, clinical stage, cases were patients who received BCT(n=24) control group were patients who received MRM(n=32).In BCT group,tangential field irradiation was used with dose of 6000cGy,Tumor bed was irradiated additional 600cGy with electron beams,7 cases of axillary metastasis were treated with axillary and supraclavicular field irradiation with dose of 5000cGy. Part of the 32 cases treated with MRM which have radiotherapy indication were treated with chest wall radiation with dose of 5000cGy,16 cases of axillary metastasis were treated with axillary and supraclavicular field irradiation with dose of 5000cGy.The differences of local recurrence rate, distant metastasis rate and disease free survival were estimated by SPSS17.0 software,and cosmetic results assessed according to RTOG criteria radiation toxicity. Results The metastasis rate,recurrence rate and survival rate were 4.2%(1/24),4.2%(1/24),and 95.8%(23/24),respectively in BCT group,and were 6.3%(2/32),6.3%(2/32),and 93.7%(30/32),respectively in MRM group.,Three patients were dead of breast cancer metastasis,one in BCT group,the others in MRM group. The overall survival (OS) and disease free survival (DFS) in MRM and BCT patients have no difference (P>0.05). according to JCRT's standard we evaluated the postoperative cosmetic,Appearances,the satisfaction rate is 95.8%(23/24).In breast-conserving therapy group,95.8%of the radiation side-effects were gradeⅠand 4.2% were gradeⅡ.Conclusion In early stage of breast cancer,the survival rate,distant metastasis rate and cosmetic effects of breast conservation surgery plus post-operative radiotherapy were satisfactory while the incidences of radiation side-effects were low. Therefore, for early breast cancer breast-conserving therapy should clearly be the best choice.