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The role of post-operative radiotherapy in the treatment of operable breast cancer

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Summary

In current practice, the management of early stage breast cancer involves a multidisciplinary cooperation among surgeons, radiation therapists, and medical oncologists. The goals of local treatment in this setting are to secure tumor control and to identify patients who are to be treated with adjuvant systemic therapy. For patients treated by mastectomy, the value of post-operative radiotherapy in primary treatment remains controversial. In this review, we examine the evolution of treatment philosophies for operable breast cancer and the results from recent clinical studies in an attempt to assess the current role of post-operative radiotherapy.

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References

  1. Portmann UV: A comparison of the results in a series of cases of carcinoma of the breast treated by postoperative roentgen therapy for prophylaxis with a similar series in which operation was the only treatment. Am J Cancer 27:1–25, 1936

    Google Scholar 

  2. Halsted WS: Results of radical operations for the cure of carcinoma of the breast. Ann Surg 46: 1–19, 1907

    Google Scholar 

  3. Handley WS: Cancer of the Breast and Its Treatment. Paul B Hoeber, New York, 1906

    Google Scholar 

  4. Chu FCH, Lin FJ, Kim JH, Huh SH, Garmatis CJ: Locally recurrent carcinoma of the breast. Cancer 37:2677–2681, 1976

    PubMed  Google Scholar 

  5. Zimmerman KW, Montagùe ED, Fletcher GH: Frequency, anatomical distribution, and management of local recurrences after definitive therapy for breast cancer. Cancer 19:67–74, 1966

    PubMed  Google Scholar 

  6. Valagussa P, Bonadonna G, Veronesi U: Patterns of relapse and survival following radical mastectomy. Analysis of 716 consecutive patients. Cancer 41:1170–1178, 1978

    PubMed  Google Scholar 

  7. Fisher B, Slack NH, Cavanaugh PJ, Gardner B, Radin RG and cooperating investigators: Postoperative radiotherapy in the treatment of breast cancer: results of the NSABP clinical trial. Ann Surg 172:711–730, 1970

    PubMed  Google Scholar 

  8. Adair FE: The role of surgery and irradiation in cancer of the breast. JAMA 121:553–558, 1943

    Google Scholar 

  9. Harrington SW: Results of surgical treatment of unilateral carcinoma of breast in women. JAMA 148:1007–1011, 1952

    Google Scholar 

  10. Fisher B, Slack N, Katrych D, Wolmark N: The year follow-up results of patients with carcinoma of the breast in a cooperative clinical trial evaluating surgical adjuvant chemotherapy. Surg Gynecol Obstet 140: 528–534, 1975

    PubMed  Google Scholar 

  11. Host H, Brennhoyd IO: The effect of post-operative radiotherapy in breast cancer. Int J Radiat Oncol Biol Phys 2:1061–1067, 1977

    PubMed  Google Scholar 

  12. Robbins GF, Lucas JC, Jr., Fracchia AA, Farrow JH, Chu FCCH: An evaluation of postoperative radiation therapy in breast cancer. Surg Gynecol Obstet 122:979–982, 1966

    PubMed  Google Scholar 

  13. Edland RW, Maldonado LG, Johnson RO, Vermund H: Post-operative irradiation in breast cancer. An evaluation of 291 cases treated at the University of Wisconsin Medical Center from 1955 through 1961. Radiology 93: 905–913, 1969

    PubMed  Google Scholar 

  14. Tapley N, Du V, Spanos WJ, Fletcher GH, Montague ED, Schell S, Oswald MJ: Results in patients with breast cancer treated by radical mastectomy and postoperative irradiation with no adjuvant chemotherapy. Cancer 49:1316–1319, 1982

    PubMed  Google Scholar 

  15. Weichselbaum RR, Marck A, Hellman S: The role of postoperative irradiation in carcinoma of the breast. Cancer 37:2682–2690, 1976

    PubMed  Google Scholar 

  16. Wallgren A: A controlled study: preoperative versus postoperative irradiation. Int J Radiat Oncol Biol Phys 2:1167–1169, 1977

    PubMed  Google Scholar 

  17. Host H: Postoperative radiotherapy in breast cancer.In Baum M, Kay R, Scheurlen H (eds): Clinical Trials in Early Breast Cancer. Birkhauser Verlag, Basel, Switzerland, 1982

    Google Scholar 

  18. Strender L, Wallgren A, Arndt J, Arner O, Bergstrom J, Blomstedt B, Granberg P, Nilsson B, Raf L, Silversward C: Adjuvant radiotherapy in operable breast cancer: correlation between dose in internal mammary nodes and prognosis. Int J Radiat Oncol Biol Phys 7:1319–1325, 1981

    PubMed  Google Scholar 

  19. Bonadonna G, Rossi A, Tancini G, Valagussa P: Adjuvant chemotherapy in breast cancer. Lancet 1:1157, 1983

    Google Scholar 

  20. Fisher B, Redmond C, Fisher ER and participating NSABP investigators: The contribution of recent NSABP clinical trials of primary breast cancer therapy to an understanding of tumor biology — an overview of findings. Cancer 46: 1009–1025, 1980

    PubMed  Google Scholar 

  21. Bonadonna G, Valagussa P, Rossi A, Zucali R, Tancini G, Bajetta E, Brambilla C, DeLena M, DiFronzo G, Banfi A, Rilko F, Veronesi U: Are surgical adjuvant trials altering the course of breast cancer? Semin Oncol 5:450–464, 1978

    PubMed  Google Scholar 

  22. Goldie JH, Goldman AJ: A mathematical model for relating the drug sensitivity of tumors to their spontaneous mutation rate. Cancer Treat Rep 63:1727–1733, 1979

    PubMed  Google Scholar 

  23. Nissen-Meyer R, Kjellgren K, Malmio K, Mansson B, Norin T: Surgical adjuvant chemotherapy. Results with one short course with cyclophosphamide after mastectomy for breast cancer. Cancer 41:2088–2098, 1978

    PubMed  Google Scholar 

  24. Bonadonna G, Valagussa P, Zucali R, DelVecchio M, Veronesi U: Feasibility of adjuvant chemotherapy plus radiotherapy in operable breast cancer.In Harris JR, Hellman S, Silen W (eds): Conservative Management of Breast Cancer. JB Lippincott, Philadelphia, 1983, pp 329–336

    Google Scholar 

  25. Botnick LE, Come S, Rose C, Goldstein M, Lange R, Tishler S, Schnipper L: Primary breast irradiation and concomitant adjuvant chemotherapy (CMF).In Harris JR, Hellman S, Silen W (eds): Conservative Management of Breast Cancer. JB Lippincott, Philadelphia, 1983, pp 321–328

    Google Scholar 

  26. Lippman ME, Lichter AS, Edwards BK, Gorrell CR, d'Angelo T, DeMoss EV: The impact of primary radiation treatment of localized breast cancer on the ability to administer systemic adjuvant chemotherapy. J Clin Oncol 2:21–27, 1984

    PubMed  Google Scholar 

  27. Ahmann DL, Payne WS, Scanlon PW, O'Fallon JR, Bisel HF, Hahn RG, Edmonson JH, Ingle JN, Frytak S, O'Connell MJ, Rubin J: Repeated adjuvant chemotherapy with phenylalanine mustard or 5-fluorouracil, cyclophosphamide, and prednisone with or without radiation, after mastectomy for breast cancer. Lancet 1:893–896, 1978

    PubMed  Google Scholar 

  28. Allen H, Brooks R, Jones SE, Chase E, Heusinkveld RS, Giordano GF, Ketchel SJ, Jackson RA, Davis S, Moon TE, Salmon SE: Adjuvant treatment for Stage II (node positive) breast cancer with adriamycin-cyclophosphamide (AC)±radiotherapy (XRT).In Salmon SE, Jones SE (eds): Adjuvant Therapy of Cancer III. Grune and Stratton, New York, 1981, pp 453–462

    Google Scholar 

  29. Buzdar A, Blumenschein GR, Smith TL, Powell KC, Hortobagyi G, Yap HY, Schell FC, Barnes BC, Amers FC, Martin RG, Hersh EM: Adjuvant chemotherapy with fluorouracil doxorubicin and cyclophosphamide, with or without Bacillus Calmette-Guerin and with or without irradiation in operable breast cancer. A prospective randomised trial. Cancer 53:384–389, 1984

    PubMed  Google Scholar 

  30. Velez-Garcia E, Moore M, Vogel CL, Marcial V, Ketcham A, Bartolucci A, Liu C, Smalley R: Postmastectomy, adjuvant chemotherapy with or without radiation therapy in women with operable breast cancer and positive axillary lymph nodes: the Southeastern Cancer Study Group experience. Breast Cancer Res Treat 3 (Suppl 1):49–60, 1983

    Google Scholar 

  31. Cooper MR, Rhyne AL, Muss HB, Ferree C, Richards F, White DR, Stuart JJ, Jackson DV, Howard V, Shore A, Spurr CL: A randomized comparative trial of chemotherapy and irradiation therapy for stage II breast cancer. Cancer 47:2833–2839, 1981

    PubMed  Google Scholar 

  32. Rodger A, Montague ED, Fletcher G: Preoperative or postoperative irradiation as adjunctive treatment with radical mastectomy in breast cancer. Cancer 51:1388–1392, 1983

    PubMed  Google Scholar 

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

    PubMed  Google Scholar 

  34. Schell SR, Montague ED, Spanos WJ, Tapley N, Fletcher GH, Oswald MJ: Bilateral breast cancer in patients with initial stage I and II disease. Cancer 50:1191–1194, 1982

    PubMed  Google Scholar 

  35. Aristizabal SA, Miller RC, Schlichtemeier AL, Jones SE, Boone ML: Adriamycin-irradiation cutaneous complications. Int J Radiat Oncol Biol Phys 2:325–331, 1977

    PubMed  Google Scholar 

  36. Hahn P, Hallberg O, Vikterlof KJ: Acute skin reactions in postoperative breast cancer patients receiving radiotherapy plus adjuvant chemotherapy. Am J Roentgenol 130:137–139, 1978

    Google Scholar 

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Authors and Affiliations

  1. Joint Center for Radiation Therapy, Department of Radiation Therapy, Harvard Medical School, 50 Binney Street, 02115, Boston, MA, USA

    Geoffrey F. Beadle & Jay R. Harris

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  1. Geoffrey F. Beadle
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  2. Jay R. Harris
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Beadle, G.F., Harris, J.R. The role of post-operative radiotherapy in the treatment of operable breast cancer. Breast Cancer Res Tr 4, 159–168 (1984). https://doi.org/10.1007/BF01806481

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