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Long-term complications associated with breast-conservation surgery and radiotherapy

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Abstract

Background

Breast-conservation surgery plus radiotherapy has become the standard of care for early-stage breast cancer; we evaluated its long-term complications.

Methods

We selected patients treated with surgery and radiotherapy between January 1990 and December 1992 (an era in which standard radiation dosages were used) with follow-up for at least 1 year. Patients were prospectively monitored for treatment-related complications. Median follow-up time was 89 months.

Results

A total of 294 patients met the selection criteria. Grade 2 or higher late complications were identified in 29 patients and included arm edema in 13 patients, breast skin fibrosis in 12, decreased range of motion in 4, pneumonitis in 2, neuropathy in 2, fat necrosis in 1, and rib fracture in 1. Arm edema was more common after lumpectomy plus axillary node dissection than after lumpectomy alone. Arm edema occurred in 18% of patients who underwent surgery plus irradiation of the lymph nodes and 10% who underwent surgery without nodal irradiation.

Conclusions

Breast-conservation surgery plus radiotherapy was associated with grade 2 or higher complications in only 9.9% of patients. Half of these complications were attributable to axillary dissection, it is hoped that lower complication rates can be achieved with sentinel lymph node biopsy.

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Authors and Affiliations

  1. Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas

    Thomas A. Buchholz MD, George H. Perkins MD, Eric A. Strom MD & Marsha D. McNeese MD

  2. Department of Breast Medical Oncology (GNH), The University of Texas M. D. Anderson Cancer Center, Houston, Texas

    Gabriel N. Hortobagyi MD

  3. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 444, 77030, Houston, TX

    Funda Meric MD, Nadeem Q. Mirza MD, MPH, Georges Vlastos MD, Frederick C. Ames MD, Merrick I. Ross MD, Raphael E. Pollock MD, PhD, S. Eva Singletary MD, Barry W. Feig MD, Henry M. Kuerer MD, PhD, Lisa A. Newman MD & Kelly K. Hunt MD

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  1. Funda Meric MD
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  2. Thomas A. Buchholz MD
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  3. Nadeem Q. Mirza MD, MPH
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  14. Marsha D. McNeese MD
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Corresponding author

Correspondence to Kelly K. Hunt MD.

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Meric, F., Buchholz, T.A., Mirza, N.Q. et al. Long-term complications associated with breast-conservation surgery and radiotherapy. Annals of Surgical Oncology 9, 543–549 (2002). https://doi.org/10.1007/BF02573889

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  • DOI: https://doi.org/10.1007/BF02573889

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