Breast Cancer

, 5:395 | Cite as

Radiation complications following breast conserving therapy

  • Hitoshi Ikushima
  • Yoshihiro Takegawa
  • Hiroaki Yasuda
  • Yumi Makimoto
  • Kenji Matsuzaki
  • Kenichi Kashihara
  • Jyunji Ueno
  • Mitsunori Sasa
  • Tadaoki Morimoto
  • Hiromu Nishitani
Original Article
Received:
Accepted:

Abstract

Background

Breast conserving therapy is being established as a standard therapeutic procedure for early breast cancer in Japan. However, the indications of radiotherapy and a standardized therapeutic procedure have not been established yet. In this study, complications following radiotherapy were evaluated in patients who had previously undergone breast conserving therapy at Tokushima University Hospital.

Methods

From October 1989 to March 1996, 60 women with stage I or II breast cancer underwent radiation therapy after breast conserving surgery, and all patients were followed-up for a median of 27 months. Radiation morbidity scoring of the breast and adjacent organs was performed using the toxity criteria of the Radiation Therapy Oncology Group (RTOG) and European Organization for Research and Treatment of Cancer (EORTC).

Results

Only 1 patient developed local recurrence, and no distant metastasis or death was observed. The cause of recurrence in 1 case was considered to be due to extended intraductal component. Although transient dermal reaction was induced by irradiation of the breast, no side effects that may cause cosmetic problems were found. No serious radiation complications were found in the lungs, ribs, heart or other adjacent organs.

Conclusions

The adverse reactions caused by irradiation does not reduce the merit of combined use of radiation therapy in breast conserving therapy, and therefore, are not the hesitation factor in application of radiotherapy.

Key words

Breast cancer Breast conserving therapy Radiation therapy Local control Complications 

Abbreviations

EIC

Extended intraductal component

RTOG

Radiation Therapy Oncology Group

EORTC

European Organization for Research and Treatment of Cancer

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

References

  1. 1).
    Atkins H: Treatment of early breast cancer; A report after 10 years of clinical trial.Br Med J 2:423–429, 1972.PubMedCrossRefGoogle Scholar
  2. 2).
    Veronesi U, Saccozzi R, Del Vecchio M,ea al: Corn-pairing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patiants with small cancers of thebreast.N Engl J Med 305:6–11,1981.PubMedGoogle Scholar
  3. 3).
    Sarrazin D, Le MG, Fontaine MF,ea al: Conservative treatment versus mastectomy in T1 or small T2 breast cancer; A randomized clinical trial. In: Harris J, Hellman S, Silen W eds, Conservative Management of Breast Cancer, J.P. Lippincott Co, Philadelphia pp101–111, 1983.Google Scholar
  4. 4).
    Fisher B, Bauer M, Margolese R,ea al: Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer.N Engl J Med 312: 665–673, 1985.PubMedGoogle Scholar
  5. 5).
    Van Dongen JA, Bartelink H, Fentiman IS,ea al: Randomized clinical trial to assess the value of breast conserving therapy in stage I and II breast cancer; EORTC 10801 trial. In: National Institutes of Health Consensus Development Conference on the Treatment of Early Stage Breast Cancer, NCI Monographs No. 11, Goverment Printing Office, Washington DC, pp15–18, 1992.Google Scholar
  6. 6).
    Mustakallio S: Treatment of breast cancer by tumor extripation and roentogen therapy instead of radical operation.J Faculty Radiol 6:23–26, 1954.CrossRefGoogle Scholar
  7. 7).
    Yamakawa T, Morimoto T, Sasa M,et al: High positive rate of pS2 expression in forefront intraductal cancerous area in breast cancer.JJCR, 1035–1040, 1994.Google Scholar
  8. 8).
    Cox JD, Stetz J, Pajak TF,ea al: Toxity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC).Int J Radiat Oncol Biol Phys 31:1341–1346, 1995.PubMedGoogle Scholar
  9. 9).
    Japanese Breast Cancer Society: The general rules for clinical and pathological recording of breast cancer.Jpn J Surg 19:612–632, 1989.CrossRefGoogle Scholar
  10. 10).
    Montague ED: Conservation surgery and radiation therapy of operable breast cancer.Cancer 53:700–704, 1984.PubMedCrossRefGoogle Scholar
  11. 11).
    Danoff BF, Haller DG, Glick JH,ea al: Conservative surgery and irradiation in the treatment of early breast cancer.Ann Intern Med 102:634–642, 1985.PubMedGoogle Scholar
  12. 12).
    Pierquin B, Raynal M, Otmezguine Y,ea al: Conservative treatment of breast cancer; Results after 10 years.Presse Med 15:375–377, 1986PubMedGoogle Scholar
  13. 13).
    Gray J, MacCormick B, Cox L,ea al: Primary breast irradiation in large-breast of heavy women; Analysis of cosmetic outcome.Int J Radiat Oncol Biol Phys 21:347–354, 1991.PubMedGoogle Scholar
  14. 14).
    Rochefordiere A, Abner A, Silver B,ea al: Are cosmetic results following conservative surgery and radiation therapy for early breast cancer dependent on technique?Int J Radiat Oncol Biol Phys 23:925–931, 1992.PubMedGoogle Scholar
  15. 15).
    Fowble B, Solin L, Schultz D,ea al: Ten year results of conservative surgery and irradiation for stage I and II breast cancer.Int J Radiat Oncol Biol Phys 21:269–277, 1991.PubMedGoogle Scholar
  16. 16).
    Harris JR, Hellman S: Conservative surgery and radiotherapy. In: Harris JR, Hellman S, Henderson JC, Kinne DW eds, Breast Disease, J.P. Lippincott Co, Philadelphia, pp299–324, 1987.Google Scholar
  17. 17).
    Stotter AT, McNeese MD, Ames FC,ea al: Predicting the rate and extent of local reginal failure after breast conservation therapy for early breast cancer.Cancer 64:2217–2225, 1989.PubMedCrossRefGoogle Scholar
  18. 18).
    Lingos TI, Recht A, Vicini F,ea al: Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy.Int J Radiat Oncol Biol Phys 21:355–360, 1991.PubMedGoogle Scholar
  19. 19).
    Boyages J, Bosch C, Langlands AO,ea al: Breast conservation; Longterm Australian data.Int J Radiat Oncol Biol Phys 24:253–260, 1992.PubMedGoogle Scholar
  20. 20).
    Mallik R, Fowler A, Hunt P: Measuring irradiated lung and heart area in breast tangential fields using a simulator-based computerized tomography device.Int J Radiat Oncol Biol Phys 31:411–417, 1995.PubMedGoogle Scholar
  21. 21).
    Cahan WG, Woodward HQ, Higinbothom NL,ea al: Sarcoma arising in irradiated bone; Report of eleven cases.Cancer 1:3–29, 1948.CrossRefPubMedGoogle Scholar
  22. 22).
    Hatfield PM, Schulz MD: Post-irradiation sarcoma including 5 cases after X-ray therapy of breast carcinoma.Radiology 96:593–602, 1970.PubMedGoogle Scholar
  23. 23).
    Taghian A, de Vathaire F, Terrier P,et al: Longterm risk of sarcoma following radiation treatment for breast cancer.Int J Radiat Biol Phys 21:361–367,1991.Google Scholar
  24. 24).
    Pierce SM, Recht A, Ligos TI,ea al: Longterm radiation complications following conservative surgery and radiation therapy in patients with early stage breast cancer.Int J Radiat Oncol Biol Phys 23:915–923, 1992.PubMedGoogle Scholar

Copyright information

© The Japanese Breast Cancer Society 1998

Authors and Affiliations

  • Hitoshi Ikushima
    • 1
  • Yoshihiro Takegawa
    • 2
  • Hiroaki Yasuda
    • 1
  • Yumi Makimoto
    • 1
  • Kenji Matsuzaki
    • 1
  • Kenichi Kashihara
    • 1
  • Jyunji Ueno
    • 1
  • Mitsunori Sasa
    • 4
  • Tadaoki Morimoto
    • 3
  • Hiromu Nishitani
    • 1
  1. 1.Department of RadiologySchool of Medicine, University of TokushimaTokushimaJapan
  2. 2.Departments of Radiological TechnologyUniversity of TokushimaJapan
  3. 3.Nursing, School of Medical SciencesUniversity of TokushimaJapan
  4. 4.Tokushima Breast Care ClinicUniversity of TokushimaJapan

Personalised recommendations