Skip to main content
SpringerLink
Log in

The current status of primary radiation therapy in the treatment of early breast cancer

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Summary

Primary radiation therapy, usually with limited surgery, is being used increasingly as an alternative to mastectomy in patients with early breast cancer. Results so far appear similar in terms of local control and overall survival. Current questions on patient selection, extent of surgery, radiation therapy technique, possible long-term complications, and the role of axillary dissection and of adjuvant therapy are reviewed. Though many questions remain, it is hoped that this alternative will contribute to improved survival along with breast preservation for improved quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Finzi NS: X-rays and radium in the treatment of carcinoma of the breast. Br Med J 2: 728–733, 1927

    Google Scholar 

  2. Grubbe E: Priority in the therapeutic use of X-rays. Radiology 21: 156–162, 1933

    Google Scholar 

  3. Keynes G: The treatment of primary carcinoma of the breast with radium. Acta Radiologica 10: 393–402, 1929

    Google Scholar 

  4. Keynes G: Conservative treatment of cancer of the breast. Br Med J 2: 643–647, 1937

    Google Scholar 

  5. Williams IG, Murley RS, Curaven MP: Cancer of the female breast: conservative and radical surgery. Br Med J 2: 787–796, 1953

    Google Scholar 

  6. Pfahler GE: Results of radiation therapy in 1,022 private cases of carcinoma of the breast from 1902 to 1928. Am J Roentgenol Radium Ther Nucl Med 27: 496–508, 1932

    Google Scholar 

  7. Baclesse F: Roentgen therapy as the sole method of treatment of cancer of the breast. Am J Roentgenol Radium Ther Nucl Med 62: 311–319, 1949

    Google Scholar 

  8. Peters MV: Cutting the ‘Gordian Knot’ in early breast cancer. Ann R Coll Phys Surg Can 8: 186–191, 1975

    Google Scholar 

  9. Clarke RM: Breast cancer — 20 years of conservative treatment.In Lewtson and Montague (eds): Diagnosis and Treatment of Breast Cancer — International Clinical Forum. Williams & Wilkins, Baltimore, 1981

    Google Scholar 

  10. Calle R, Pilleron JP, Schlienger P, Vilcoq JR: Conservative management of operable breast cancer. Cancer 42: 2045, 1978

    PubMed  Google Scholar 

  11. Pierquin B, Owen R, Maylin C, Otmezguine Y, Raynal M, Mueller W, Hannoun S: Radical radiation therapy of breast cancer. Int J Radiat Oncol Biol Phys 6: 17–30, 1980

    PubMed  Google Scholar 

  12. Pierquin B, Baillet F, Wilson JF: Radiation therapy in the management of primary breast cancer. Am J Roentgenol 127: 645–648, 1976

    Google Scholar 

  13. Sarrazin D, Fontaine F, Lé M, Mouriesse H: Données actuelles sur la radiothérapie du cancer du sein. Bull Cancer 62: 373, 1975

    PubMed  Google Scholar 

  14. Spitalier J, Brandone H, Ayme Y, Amalric R, Santamaris F, Seigle J: Cesiumtherapy of breast cancer. A five year report on 400 consecutive patients. Int J Radiat Oncol Biol Phys 2: 231, 1977

    PubMed  Google Scholar 

  15. Chu A, Cope O, Russo R, Wang CC, Schulz M, Wang C, Rodkey G: Treatment of early stage breast cancer by limited surgery and radical irradiation. Int J Radiat Oncol Biol Phys 6: 25–30, 1980

    PubMed  Google Scholar 

  16. Balawajder I, Antich P, Boland J: The management of breast cancer by primary radiotherapy at Mount Sinai Hospital from 1962–1979. Cancer 49: 1587–1596, 1982

    PubMed  Google Scholar 

  17. Prosnitz LR, Goldenberg IS, Packard RA, Levene MB, Harris JR, Hellman S, Wallner P, Brady L, Mansfield C, Kramer S: Radiation therapy as initial treatment for early stage cancer of the breast without mastectomy. Cancer 39: 917–923, 1977

    PubMed  Google Scholar 

  18. Ghossein NA, Stacey P, Alpert S, Ager P, Krishnaswany V: Local control of breast cancer with tumorecto ny plus radiotherapy or radiotherapy alone. Radiology 121: 455–459, 1976

    PubMed  Google Scholar 

  19. Montague ED, Gutierrez AE, Barker JL, Tapley ND, Fletcher GH: Conservative surgery and irradiation for the treatment of favorable breast cancer. Cancer 43: 1058, 1979

    PubMed  Google Scholar 

  20. Bedwinek J, Perez C, Kramer S, Brady L, Goodman R, Grundy G: Irradiation as the primary management of stage I and II adenocarcinoma of the breast. Analysis of the RTOG breast registry. Cancer Clinical Trials 3: 11–18, 1980

    PubMed  Google Scholar 

  21. Harris JR, Botnick LE, Bloomer WD, Chaffey JT, Hellman S: Primary radiation therapy for early breast cancer: the experience at the Joint Center for Radiation Therapy. Int J Radiat Oncol Biol Phys 7: 1549–1559, 1981

    PubMed  Google Scholar 

  22. Svensson G, Bjarngard B, Larsen R, Levene MB: A modified three-field technique for breast treatment. Int J Radiat Oncol Biol Phys 6: 689–694, 1980

    PubMed  Google Scholar 

  23. Siddon R, Buck B, Harris JR, Svensson G: Three-field technique for breast irradiation using tangential field corner blocks. (Submitted.)

  24. Harris JR, Levene MB, Svensson G, Hellman S: Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys 5: 257–261, 1979

    PubMed  Google Scholar 

  25. Veronesi U, Saccozzi R, DelVecchio M, Banfi A, Clement C, DeLena M, Gallus G, Greco M, Luini A, Marubini E, Muscolino G, Rilke F, Salvador B, Zecchini A, Zucali R: Comparing radical mastectomy with quadrantectomy, axillary dissection and radiotherapy in patients with small cancers of the breast. N Engl J Med 305: 6, 1981

    PubMed  Google Scholar 

  26. Alderson MR, Jackson SM: Long-term follow-up of patients with menorrhagia treated by irradiation. Br J Radiology 44: 295–299, 1971

    Google Scholar 

  27. Brinkley D, Haybittle JL: The late effects of artificial menopause by X-radiation. Br J Radiol 42: 519–521, 1969

    PubMed  Google Scholar 

  28. Doll R, Smith PG: The long-term effects of artificial menopause by X-irradiation in patients treated for metropathia hemorrhagia. Br J Radiol 41: 362–368, 1968

    PubMed  Google Scholar 

  29. Boice JR, Hutchinson GB: Leukemia in women following radiotherapy for cervical cancer: 10 year follow-up of an international study. JNCI 65: 115–129, 1980

    PubMed  Google Scholar 

  30. Simon N, Brucer M, Hayes R: Radiation and leukemia in carcinoma of the cervix. Radiology 74: 905–911, 1960

    PubMed  Google Scholar 

  31. Zippin C, Bailer JC, Hohn HI, Lum P, Eisenberg H: Radiation for cervical cancer - late effects on life span and on leukemia incidence. Cancer 28: 937–942, 1971

    PubMed  Google Scholar 

  32. Cook DC, Dent O, Hewitt D: Breast cancer following multiple chest fluoroscopy: the Ontario experience. Can Med Assoc J 111: 406–410, 1974

    PubMed  Google Scholar 

  33. Boice Jr JD, Monson RR: Breast cancer in women after repeated fluoroscopic examinations of the chest. J Natl Cancer Inst 59: 823–832, 1977

    PubMed  Google Scholar 

  34. Tokunaga M, Norman JE, Asano M, Tokuoka S, Ezaki H, Nishimori I, Tsuji Y: Malignant breast tumors among atomic bomb survivors, Hiroshima and Nagasaki, 1950–1974. J Natl Cancer Inst 62: 1347–1359, 1979

    PubMed  Google Scholar 

  35. McCredie JA, Inch WR, Alderson M: Consecutive primary carcinomas of the breast. Cancer 35: 1472–1477, 1975

    PubMed  Google Scholar 

  36. Rose CM, Botnick LE, Goodman R, Harris JR, Findlay P, Richter M, Silen W, Hellman S: The role of limited axillary sampling in the treatment of breast cancer by primary irradiation (In press)

  37. Fischer B, Wolmark N, Redmond C, et al.: The accuracy of clinical nodal staging and of limited axillary dissection as a determinant of histologic nodal status in carcinoma of the breast. Surg Gynecol Obstet 152: 765–772, 1981

    PubMed  Google Scholar 

  38. deMoss EV, Lichter A, Lippman M, Gerber N, Reichert C, Edwards B, Schain W, Gorrell C, D'Angelo T, Rosenberg S: Complete axillary dissection.In S Hellman, JR Harris, and W Silen (eds): Alternatives to Mastectomy. JB Lippincott, Philadelphia. (In press)

  39. Bonadonna G, Valagussa P, Zuceli R, DelVecchio M, Veronesi U: Feasibility of adjuvant chemotherapy plus radiotherapy in operable breast cancer.In JR Harris, S Hellman and W Silen (eds): Alternatives to Mastectomy, JB Lippincott, Philadelphia. (In press)

  40. Botnick LE, Come S, Rose C, Goldstein M, Lange R, Tishler S, Schnipper L: Primary breast irradiation and concomitant adjuvant chemotherapy (CMF). (Submitted)

  41. Glick JH, Danoff BF, Haller D, Weila C, Goodman R: Adjuvant chemotherapy in patients undergoing definitive irradiation for primary breast cancer: The University of Pennsylvania experience.In JR Harris, S Hellman and W Silen (eds): Alternatives to Mastectomy. JB Lippincott, Philadelphia. (In press)

  42. Lichter A, Lippman ME, deMoss EV, et al.: The influence of primary breast cancer treatment — mastectomy or excisional biopsy plus radiation — on the ability to deliver adjuvant chemotherapy (Abstract). Proc Am Soc Clin Oncol 23(1): 81, 1982

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Joint Center for Radiation Therapy, Department of Radiation Therapy, Harvard Medical School, Boston, Massachusetts, USA

    Nancy Tarbell Leslie M.D., Jay R. Harris M.D. & Samuel Hellman M.D.

Authors
  1. Nancy Tarbell Leslie M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jay R. Harris M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Samuel Hellman M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Address for reprints: Dr Nancy Tarbell Leslie, Joint Center for Radiation Therapy, Dept. of Radiation Therapy, Harvard Medical School, 50 Binney Street, Boston, MA 02115, USA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leslie, N.T., Harris, J.R. & Hellman, S. The current status of primary radiation therapy in the treatment of early breast cancer. Breast Cancer Res Tr 2, 213–220 (1982). https://doi.org/10.1007/BF01806933

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01806933

Keywords

Search

Navigation