Abstract:

Objective

To evaluate the long-term survival，ipsilateral breast recurrence（IBR）and cosmetic results of breast conservative therapy（BCT）for stage Ⅰ and Ⅱ breast cancer.

Method

From Oct.1985 to Dec.2000，BCT were performed in 270 patients with stage Ⅰ and Ⅱ breast cancer.Breast conserving surgery included quadrantectomy，sector resection，and lumpectomy，combined with whole axillary lymph node dissection.⁶⁰Co and accelerator were used for whole breast and booster irradiations.

Results

Median follow up of 10 years showed the 10-year overall survival，IBR，and distant metastasis rates were 83.7%，8.5%，and 23.7%，respectively in the 270 patients.While patient age，tumor size，histopathological type，and axillary node status had no relationship with IBR（P﹥0.05 for all），IBR was significantly high in patients with positive margin and without postoperative whole breast radiation（P=0.000）.Under the circumstance of assured clear margins，there was no difference of IBR between quadrantectomy/sector resection and lumpectomy（P=0.799），but the former had poor cosmetic results（P﹤0.05）.

Conclusions

①BCT has the effect of high rate of long-term survival，low rate of IBR and good cosmetic results，and can safely replace mastectomy for patients with stage Ⅰ and Ⅱ breast cancer；②Clear margin and whole breast irradiation are still gold standard for BCT at the moment；③Lumpectomy has better cosmetic results and same curative effect compared to quadrantectomy/sector resection.

Key words: Breast cancer, Breast conserving therapy, Ipsilateral breast recurrence, Cosmetic results