Abstract
Breast cancer is the most common type of cancer in women throughout the world (18%), with a yearly morbidity that is already over half a million. Its incidence in Hungary is increasing in each age group, and the mortality is strikingly high. This study was conducted to assess the effectiveness of breast-conserving surgery in comparison to more radical surgery on a large group of patients. During the 15 years between 1980 and 1994, a total of 6,358 patients with primary breast cancer underwent surgery at the National Institute of Oncology in Budapest, Hungary, as breast-conserving surgery in 2,026 patients (31.8%). Breast-conserving surgery is being performed in an ever-increasing number of patients, followed by adjuvant radiochemotherapy in premenopausal patients, or radiohormone therapy in menopausal patients. During follow-up, recurrence was found in only 5.9% of the patients who underwent breast-conserving treatment. Thus, according to our experience, breast conservation therapy for the management of breast cancer offers favorable results, provided that the preconditions to this treatment are adequately met.
Similar content being viewed by others
References
Fukotomi T, Kobayashi Y, Nanasawa T, Yamamoto H, Tsuda H (1993) A clinicopathological analysis of breast cancer in patients with family history. Surg Today (Jpn J Surg) 23:849–854 [ref.: Mishima Y (1994) Br J Surg 81:353–354]
Tsuchiya A, Katagata N, Kimijima I, Abe R (1993) Immunhistochemical overexpression of c-erb B-2 in the prognosis of breast cancer. Surg Today (Jpn J Surg) 23:885–890 [ref.: Mishima Y (1994) Br J Surg 81:353–354]
Hirayama R, Sawai S, Takagi Y, Mishima Y, Kimura N, Shimada N, Esaki Y, Kurashima C, Utsuyama M, Hirokawa K (1991) Positive relationship between expression of anti-metastatic factor (nm 23 gene product or nucleoside diphosphate kinase) and good prognosis in human breast cancer. J Natl Cancer Inst 83:1249–1250
Hayward JL (1983) The Guy's Hospital trials on breast conservation. In: Harris JR, Hellman S, Silen W (eds) Conservative management of breast cancer. Lippincott, Philadelphia, pp 77–90
Veronesi U, Saccozzi R, Del Vecchio M, Banfi A, Clemente C, De Lena M, Gallus G, Greco M, Luini A, Marubini E, Muscolino G, Rilke F, Salvadori B, Zecchini A, Zucali R (1981) Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast. N Engl J Med 305:6–11
Fisher B, Bauer M, Margolese R, Poisson R, Pilch Y, Redmond C, Fisher E, Wolmark N, Deutsch M, Montague E, Saffer E, Wickerham L, Lerner H, Glass A, Shibata J, Deckers P, Ketcham A, Oishi R, Russell I (1985) Five-year results of a randomized clinical trial comparing total mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 312:665–673
Sarrazin D, Lé MG, Arriagada R, Contesso G, Fontaine F, Spelmann M, Rochard F, Le Chevalier T, Lecour J (1989) Ten-year results of randomized trial comparing a conservative treatment to mastectomy in early breast cancer. Institut Gustave Roussy. Radiother Oncol 14:177–184
Chaudary MM, Girling A, Girling S, Habib F, Millis RR, Hayward J (1988) New lumps in the breast following conservation treatment for early breast cancer. Breast Cancer Res Treat 11:51–58
Buchberger W, Hamberger L, Schön G, Steixner G, Fritsch E (1991) Mammographie und Sonographie in der Rezidividagnostik nach brusterhaltender Therapie des Mammakarzinoms. RÖFO Fortschr Geb Röntgenstr Nuklearmed 154:650–656
Harris J, Recht A, Connolly J, Cady B, Come S, Henderson C, Koufman C, Love S, Schnitt S, Osteen R (1990) Conservative surgery and radiotherapy for early breast cancer. Cancer 66:1427–1438
Kurtz JM, Amalric R, Brandone H, Ayme Y, Jacquemier J, Pietra JC, Hans D, Pollet JF, Bressac C, Spitalier JM (1989) Local recurrence after breast-conserving surgery and radiotherapy. Frequency, time course and prognosis. Cancer 63:1912–1917
Fowble B, Solin LJ, Schultz DJ, Rubenstein J, Goodman RL (1990) Breast recurrence following conservative surgery and radiation: patterns of failure, prognosis and pathologic findings from mastectomy specimens with implications for treatment. Int J Radiat Oncol Biol Phys 19:833–842
Veronesi U, Luini A, Beretta E, Boracchi P, Del Vecchio M, Farante G, Galimberti V, Marubini E, Mezzanotte G, Sacchini V, Salvadori B, Tana S, Zucali R (1990) Conservative treatment of early breast cancer. Long term results of 1,232 cases treated with quadrantectomy, axillary dissection and radiotherapy. Ann Surg 211:250–259
Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, Fisher E, Deutsch M, Caplan R, Pilch Y, Glass E, Shibata H, Lerner H, Terz J, Sidorovich L (1989) Eight-year results of a randomized clinical trial comparing mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 320:822–829
Greening WP, Montgomery AC, Gordon AB, Gowing NFC (1988) Quadrantic excision and axillary node dissection without radiation therapy: the long term results of a selective policy in the treatment of stage I breast cancer. Eur J Surg Oncol 14:221–225
Nemoto T, Patel JK, Rosner D, Dao TL, Schuh M, Penetrante R (1991) Factors affecting recurrence in lumpectomy without irradiation for breast cancer. Cancer 67:2079–2082
Hermann RE, Grundfest-Broniatowski S, Esselstyn CB (1992) Breast conserving surgery: How much is enough? Sem Surg Oncol 8:136–139
Cady B, Stone MD, Wayne J (1993) New therapeutic possibilities in primary invasive breast cancer. Ann Surg 218:338–349
Silverstein MJ, Gierson ED, Waisman JR, Senofsky GM, Colburn WJ, Gamagami P (1994) Axillary lymph node dissection for T1a breast carcinoma: Is it indicated? Cancer 73:664–667
Cady B (1994) The need to reexamine axillary lymph node dissection in invasive breast cancer. Cancer 73:505–508
Boyages J, Recht A, Connolly JL, Schnitt SJ, Gelman R, Kooy H, Love S, Osteen RT, Cady B, Silver B (1990) Early breast cancer: predictors of breast recurrence for patients treated with conservative surgery and radiotherapy. Radiother Oncol 19:29–41
Dubois JB, Saumon M, Reme M, Gary-Bobo J, Pourquier H, Pujol H (1990) Tumorectomy and radiation therapy in early breast cancer: a report on 392 patients. Radiology 175:867–871
Kurtz JM, Jaquemier J, Amalric R, Brandone H, Ayme Y, Hans D, Bressac C, Spitalier JM (1990) Why are local recurrences after breast-conserving therapy more frequent in younger patients? J Clin Oncol 8:591–598
Seitz W, Stanek C, Stadler B, Binder W, Jakesz R, Reiner G (1990) Interstitielle Radiotherapie des Mammakarzinoms. Strahlenther Onkol 166:654–658
Stadler B, Staffen A, Strasser K, Wrba F, Stanek C (1990) Prognostic factors for local recurrence in patients with limited surgery and irradiation of breast cancer. Strahlenther Onkol 166:453–456
Fisher B, Costantino J, Redmond C, Poisson R, Bowman D, Couture J, Dimitrov NV, Wolmark N, Wickerham DL, Fisher E, Margolese R, Robidoux A, Shibata H, Terz J, Paterson AHG, Feldman MI, Farrar W, Evans J, Lickley HL, Ketner M, et al. (1989) A randomized clinical trial evaluating tamoxifen in the treatment of patients with node-negative breast cancer who have estrogen-receptor-positive tumors. 320:479–484
Ames FC, Balch CM (1990) Management of local and regional recurrence after mastectomy or breast-conserving treatment. Surg Clin North Am 70:1115–1124
Recht A, Sadowsky NL, Cady B (1990) Clinical problems in follow-up patients after coservative surgery and radiotherapy. 70:1179–1186
Balch CM, Singletary SE, Bland KI (1993) Clinical decision-making in early breast cancer. Ann Surg 217:207–225
Jacquemier J, Kurtz JM, Amalric R, Brandone H, Ayme Y, Spitalier JM (1990) An assessment of extensive intraductal component as a risk factor for local recurrence after breast conserving therapy. Br J Cancer 61:873–876
Aaronson NK, Bartelink H, van Dongen JA, van Dam FSAM (1988) Evaluation of breast conserving therapy: clinical, methodological and psychological perspectives. Eur J Surg Oncol 14:133–140
Veronesi U, Farante G, Galimberti V, Greco M, Luini A, Sacchini V, Andreola S, Leoni F, Ménard S, Ronco M, Colnaghi MI (1991) Evaluation of resection margins after breast conservative surgery with monoclonal antibodies. Eur J Surg Oncol 17:338–341
Osteen RT (1994) Selection of patients for breast conserving surgery. Cancer Supplement 74:366–371
Bohmert H (1989) Begriff der Mastektomie: Indikation und Zeitpunkt der Rekonstruktion. Chirurg 60:608–610
Schuster RH, Rotter S, Boon W, Efron G (1990) The use of tissue expanders in immediate breast reconstruction following mastectomy for cancer. Br J Plast Surg 43:413–418
Farrow DC, Hunt WC, Samet JM (1992) Geographic variation in the treatment of localized breast cancer. N Engl J Med 326:1097–1101
Nattinger AB, Gottlieb MS, Veum J, Yahnke D, Goodwin JS (1992) Geographic variation in the use of breast-conserving treatment for breast cancer. N Engl J Med 326:1102–1107
Izuo M, Ishida T (1994) Changing practices in the surgical treatment of breast cancer in Japan: a nationwide survey by the Japanese Breast Cancer Society. Surg Today (Jpn J Surg) 24:133–136
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Besznyák, I., Svastics, E. An analysis of breast cancer in hungary: Experience of the national institute of oncology, Budapest. Surg Today 26, 362–367 (1996). https://doi.org/10.1007/BF00311609
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00311609