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Cancer of the breast: The role of radiation therapy after mastectomy
Journal article   Open access   Peer reviewed

Cancer of the breast: The role of radiation therapy after mastectomy

Luther W. Brady, Gilbert H. Fletcher and Seymour H. Levitt
Cancer, v 39(6), pp 2868-2874
Jun 1977
DOI: https://doi.org/10.1002/1097-0142(197706)39:6<2868::AID-CNCR2820390674>3.0.CO;2-2
PMID: 326383
url
https://doi.org/10.1002/1097-0142(197706)39:6<2868::AID-CNCR2820390674>3.0.CO;2-2View
Published, Version of Record (VoR) Open

Abstract

Breast cancer represents the most common malignancy in women accounting for at least 25% of all cancers in women. The survival pattern for five‐year periods since 1940 to 1969 show a similarity of death patterns indicating that patients continue to die of their disease up to 15 and 20 years after diagnosis. Proper management of early stage disease remains an enigma despite repeated clinical studies of alternative treatment techniques. With the advent of more effective screening techniques, more patients are being shown to have disseminated disease at the time of initial diagnosis, clinically unsuspected. From these data, major factors have emerged which allow for the prediction of the ultimate survival of the patient with breast cancer. The successful treatment for breast cancer must be measured not only by survival but by local and regional control of the disease process. Local treatment, whether surgical, radiotherapeutic, or a combination of both, only influences the disease process within the treated area and can have no significant effect on occult distant metastases already present at the time of the initial treatment. Local treatment can, however, control disease on the chest wall and in the regional lymphatics of the breast. The role of radiation therapy in the management of carcinoma of the breast varies widely depending upon the extent and the rate of progression of the disease. Freedom from local‐regional tumor is of immeasurable benefit to patients whose quality of life is thus profoundly improved. Continued evaluation of therapeutic modalities available for the treatment of carcinoma of the breast has failed to answer basic questions. Data are now available to support the need for postoperative radiation therapy in selected groups of patients. Waiting until there is local or regional recurrence of breast cancer only allows for associated dissemination of the disease. The majority of patients presenting with chest wall recurrence also have disseminated disease at the same time. It must be emphasized that selection in almost all series blurrs the results. Therefore, caution is mandatory in their interpretation. The ultimate appropriate treatment program in light of the data presently available may prove to be surgery, postoperative radiation therapy, and long‐term chemoprophylaxis.

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