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Annals of Surgical Oncology

, Volume 9, Issue 6, pp 543–549 | Cite as

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

  • Funda Meric
  • Thomas A. Buchholz
  • Nadeem Q. Mirza
  • Georges Vlastos
  • Frederick C. Ames
  • Merrick I. Ross
  • Raphael E. Pollock
  • S. Eva Singletary
  • Barry W. Feig
  • Henry M. Kuerer
  • Lisa A. Newman
  • George H. Perkins
  • Eric A. Strom
  • Marsha D. McNeese
  • Gabriel N. Hortobagyi
  • Kelly K. Hunt
Original Articles

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.

Key Words

Breast cancer Radiotherapy Complication Morbidity Arm edema 

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Copyright information

© The Society of Surgical Oncology, Inc 2002

Authors and Affiliations

  • Funda Meric
    • 3
  • Thomas A. Buchholz
    • 1
  • Nadeem Q. Mirza
    • 3
  • Georges Vlastos
    • 3
  • Frederick C. Ames
    • 3
  • Merrick I. Ross
    • 3
  • Raphael E. Pollock
    • 3
  • S. Eva Singletary
    • 3
  • Barry W. Feig
    • 3
  • Henry M. Kuerer
    • 3
  • Lisa A. Newman
    • 3
  • George H. Perkins
    • 1
  • Eric A. Strom
    • 1
  • Marsha D. McNeese
    • 1
  • Gabriel N. Hortobagyi
    • 2
  • Kelly K. Hunt
    • 3
  1. 1.Department of Radiation OncologyThe University of Texas M. D. Anderson Cancer CenterHouston
  2. 2.Department of Breast Medical Oncology (GNH)The University of Texas M. D. Anderson Cancer CenterHouston
  3. 3.Department of Surgical OncologyThe University of Texas M. D. Anderson Cancer CenterHouston

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