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Breast Cancer

, Volume 16, Issue 1, pp 49–57 | Cite as

The treatment outcome of patients undergoing breast-conserving therapy: the clinical role of postoperative radiotherapy

  • Atsushi OouchiEmail author
  • Koh-ichi Sakata
  • Hideji Masuoka
  • Mitsuharu Tamakawa
  • Hisayasu Nagakura
  • Masanori Someya
  • Kensei Nakata
  • Kazuaki Asaishi
  • Minoru Okazaki
  • Yutaka Okazaki
  • Tousei Ohmura
  • Masato Hareyama
  • Masakazu Hori
  • Izuru Shimokawara
  • Akira Okazaki
  • Yoshiki Watanabe
  • Tsuyoshi Yamada
  • Tomokazu Yuyama
  • Taishi Satoh
  • Koichi Hirata
Original Article

Abstract

Background

Treatment outcome was evaluated in patients who underwent breast-conserving therapy and tangential irradiation. After verifying background factors including systemic therapy, the clinical efficacy of postoperative irradiation was investigated.

Method

There were 708 study subjects, all of whom had early breast cancer treated between 1992 and 2002. The median follow-up period was 83 months. After breast-conserving surgery, in patients with negative surgical margins, only tangential irradiation at 48 Gy/24 fr was performed. In contrast, in those with positive surgical margins, 10 Gy of radiation boost to the tumor bed with electrons was administered after tangential irradiation with 50 Gy/25 fr. Treatment outcome was analyzed using the Kaplan–Meier method and Cox’s proportional hazards regression model.

Results

The disease-free survival and no-recurrence rates within the ipsilateral breast after 5 years were 93.4 and 97.2%, respectively. Risk factors for recurrence within the ipsilateral breast included younger age of patient, the number of positive lymph nodes, and no endocrine therapy. However, the surgical margin was not a risk factor. Risk factors for relapse outwith the ipsilateral breast included younger age, the number of positive lymph nodes, and recurrence within the ipsilateral breast.

Conclusions

From our analysis of 708 Japanese women who received breast-conserving therapy, which can be regarded as a standard method in Japan, the treatment outcome was compatible with previous reports from other countries.

Keywords

Breast cancer Radiation therapy Breast-conserving therapy Radiation boost Local control 

Abbreviations

NRRB

No recurrence rate within ipsilateral breast

DFSR

Disease-free survival rate

y.o

Years old

fr

Fraction

Tm

Tumorectomy

Bp

Wide excision

Bq

Quadrantectomy

RTP

Radiation treatment planning device

SC-irradiation

Irradiation to the ipsilateral supraclavicular nodal region

ER

Estrogen receptor

PgR

Progesterone receptor

K–M method

The Kaplan–Meier method

Notes

Acknowledgments

We thank Fumio Sakauchi MD. Ph.D. (Department of Public Health, Sapporo Medical University School of Medicine) for advice on statistical analysis.

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Copyright information

© The Japanese Breast Cancer Society 2008

Authors and Affiliations

  • Atsushi Oouchi
    • 1
    • 2
    Email author
  • Koh-ichi Sakata
    • 2
  • Hideji Masuoka
    • 3
  • Mitsuharu Tamakawa
    • 2
  • Hisayasu Nagakura
    • 4
  • Masanori Someya
    • 2
  • Kensei Nakata
    • 2
  • Kazuaki Asaishi
    • 3
  • Minoru Okazaki
    • 5
  • Yutaka Okazaki
    • 6
  • Tousei Ohmura
    • 7
  • Masato Hareyama
    • 2
  • Masakazu Hori
    • 2
  • Izuru Shimokawara
    • 3
  • Akira Okazaki
    • 5
  • Yoshiki Watanabe
    • 5
  • Tsuyoshi Yamada
    • 6
  • Tomokazu Yuyama
    • 6
  • Taishi Satoh
    • 2
  • Koichi Hirata
    • 7
  1. 1.Department of RadiologyTeine Keijinkai HospitalSapporoJapan
  2. 2.Department of RadiologySapporo Medical University, School of MedicineSapporoJapan
  3. 3.Sapporo Kotoni Nyuusen ClinicSapporoJapan
  4. 4.Department of RadiologyKKR Sapporo Medical CenterSapporoJapan
  5. 5.Sapporo Nyuusen Geka ClinicSapporoJapan
  6. 6.Shinsapporo Nyuusen ClinicSapporoJapan
  7. 7.First Department of SurgerySapporo Medical University, School of MedicineSapporoJapan

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