Bilateral breast carcinoma treated with definitive irradiation
Identifieur interne : 00DF56 ( Main/Exploration ); précédent : 00DF55; suivant : 00DF57Bilateral breast carcinoma treated with definitive irradiation
Auteurs : Lawrence J. Solin [États-Unis] ; Barbara L. Fowble [États-Unis] ; Delray J. Schultz [États-Unis] ; Robert L. Goodman [États-Unis]Source :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 1989.
Abstract
From 1977 to 1987, 30 women were treated with definitive irradiation following breast-conserving surgery for bilateral carcinoma of the breast for a total of 60 treated breasts. Eleven women presented with concurrent bilateral carcinoma, and 19 women had sequential bilateral carcinoma. Pathologic axillary staging was performed in 51 of the60 treated breasts. A total dose of ≥6,000 cGy was delivered from breast tangential irradiation plus an electron or Iridium boost to 95% (5760) of the treated breasts. A third field was used to treat the regional axillary and supraclavicular lymph nodes bilaterally in three women (10%) and unilaterally in ten women (33%). Tangential fields were matched at midline in 17 patients, and in ten patients, the tangential fields overlapped by up to 3 cm on skin. In two patients, the tangential fields were matched to an internal mammary nodal field, and in one patient, tangential fields were matched to a mediastinal field given for postoperative radiotherapy for lung cancer. For the overall group of 30 patients, the 5-year actuarial NED survival following treatment of the first breast cancer was 79%, and the 5-year actuarial relapse-free survival was 72%. For the 60 treated breasts, the 5-year actuarial local failure rate was 6%. An analysis of complications and cosmesis showed results similar to previously reported results for unilateral breast cancer. These results show that definitive irradiation following breast-conserving surgery for patients with bilateral breast cancer can technically be delivered with low complication rates and with acceptable survival and local control rates. Definitive irradiation should be considered as an acceptable alternative treatment to bilateral mastectomy for appropriately selected patients with concurrent or sequential bilateral early stage carcinoma of the breast.
Url:
DOI: 10.1016/0360-3016(89)90438-0
Affiliations:
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Goodman</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:6BC80ECB234CC022AD7927A8694E7F5461908CE6</idno><date when="1989" year="1989">1989</date><idno type="doi">10.1016/0360-3016(89)90438-0</idno><idno type="url">https://api.istex.fr/document/6BC80ECB234CC022AD7927A8694E7F5461908CE6/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">003241</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">003241</idno><idno type="wicri:Area/Istex/Curation">003241</idno><idno type="wicri:Area/Istex/Checkpoint">005716</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">005716</idno><idno type="wicri:doubleKey">0360-3016:1989:Solin L:bilateral:breast:carcinoma</idno><idno type="wicri:Area/Main/Merge">00EC06</idno><idno type="wicri:Area/Main/Curation">00DF56</idno><idno type="wicri:Area/Main/Exploration">00DF56</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Bilateral breast carcinoma treated with definitive irradiation</title><author><name sortKey="Solin, Lawrence J" sort="Solin, Lawrence J" uniqKey="Solin L" first="Lawrence J." last="Solin">Lawrence J. Solin</name><affiliation wicri:level="1"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:regionArea><wicri:noRegion>University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:noRegion></affiliation></author><author><name sortKey="Fowble, Barbara L" sort="Fowble, Barbara L" uniqKey="Fowble B" first="Barbara L." last="Fowble">Barbara L. Fowble</name><affiliation wicri:level="1"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:regionArea><wicri:noRegion>University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:noRegion></affiliation></author><author><name sortKey="Schultz, Delray J" sort="Schultz, Delray J" uniqKey="Schultz D" first="Delray J." last="Schultz">Delray J. Schultz</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Statistics, University of Pennsylvania Cancer Center, Philadelphia, PA</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Goodman, Robert L" sort="Goodman, Robert L" uniqKey="Goodman R" first="Robert L." last="Goodman">Robert L. Goodman</name><affiliation wicri:level="1"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Radiation Oncology, University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:regionArea><wicri:noRegion>University of Pennsylvania School of Medicine and the Fox Chase Cancer Center</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">International Journal of Radiation Oncology, Biology, Physics</title><title level="j" type="abbrev">ROB</title><idno type="ISSN">0360-3016</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1989">1989</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="263">263</biblScope><biblScope unit="page" to="271">271</biblScope></imprint><idno type="ISSN">0360-3016</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0360-3016</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">From 1977 to 1987, 30 women were treated with definitive irradiation following breast-conserving surgery for bilateral carcinoma of the breast for a total of 60 treated breasts. Eleven women presented with concurrent bilateral carcinoma, and 19 women had sequential bilateral carcinoma. Pathologic axillary staging was performed in 51 of the60 treated breasts. A total dose of ≥6,000 cGy was delivered from breast tangential irradiation plus an electron or Iridium boost to 95% (5760) of the treated breasts. A third field was used to treat the regional axillary and supraclavicular lymph nodes bilaterally in three women (10%) and unilaterally in ten women (33%). Tangential fields were matched at midline in 17 patients, and in ten patients, the tangential fields overlapped by up to 3 cm on skin. In two patients, the tangential fields were matched to an internal mammary nodal field, and in one patient, tangential fields were matched to a mediastinal field given for postoperative radiotherapy for lung cancer. For the overall group of 30 patients, the 5-year actuarial NED survival following treatment of the first breast cancer was 79%, and the 5-year actuarial relapse-free survival was 72%. For the 60 treated breasts, the 5-year actuarial local failure rate was 6%. An analysis of complications and cosmesis showed results similar to previously reported results for unilateral breast cancer. These results show that definitive irradiation following breast-conserving surgery for patients with bilateral breast cancer can technically be delivered with low complication rates and with acceptable survival and local control rates. Definitive irradiation should be considered as an acceptable alternative treatment to bilateral mastectomy for appropriately selected patients with concurrent or sequential bilateral early stage carcinoma of the breast.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Solin, Lawrence J" sort="Solin, Lawrence J" uniqKey="Solin L" first="Lawrence J." last="Solin">Lawrence J. Solin</name></noRegion><name sortKey="Fowble, Barbara L" sort="Fowble, Barbara L" uniqKey="Fowble B" first="Barbara L." last="Fowble">Barbara L. Fowble</name><name sortKey="Goodman, Robert L" sort="Goodman, Robert L" uniqKey="Goodman R" first="Robert L." last="Goodman">Robert L. Goodman</name><name sortKey="Schultz, Delray J" sort="Schultz, Delray J" uniqKey="Schultz D" first="Delray J." last="Schultz">Delray J. Schultz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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