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Radiotherapy After Lumpectomy for Breast Cancer in Very Old Women

Deutsch, Melvin, M.D., F.A.C.R.

American Journal of Clinical Oncology: February 2002 - Volume 25 - Issue 1 - p 48-49

During a 15-year period, 47 women aged 80 to 89 years, with 48 breast cancers, were treated with postlumpectomy radiotherapy after lumpectomy alone (31 breast cancers) or lumpectomy and axillary dissection (17 breast cancers). Forty-three breast cancers in 42 women were invasive carcinomas, and 5 women had ductal carcinoma in situ. Forty-six breasts were treated with whole breast irradiation with a usual dose of 5,000 cGy in 25 fractions. Six women were treated with accelerated regimens of 250 cGy/d to 300 cGy/d to 4,000 cGy to 4,500 cGy. An additional boost to the operative area was administered to 34 breasts. Two women were treated with radiotherapy just to the operative area of the involved breast with 3,600 cGy and 3,700 cGy in 10 fractions, respectively. Thirty-four women received adjuvant tamoxifen. Twenty-five women (53.2%) are alive and free of disease at 21 to 156 months from surgery (median: 43 months). Seventeen women died at 14 to 159 months after surgery (median: 65.5 months). Twelve of these women survived greater than 5 years from treatment. Distant metastases have developed in only two women. One died at 68 months after treatment and one is alive with disease at 34 months. There are no patients with known local–regional recurrence. Radiotherapy was well tolerated in all patients, and the majority had a good to excellent cosmetic result. Age alone is not a contraindication to the administration of postlumpectomy breast irradiation.

From the Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.

Address correspondence and reprint requests to Dr Melvin Deutsch, Department of Radiation Oncology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, U.S.A.

Results of this study were presented at the 86th Annual RSNA Meeting, Chicago, Illinois, November 28, 2000.

© 2002 Lippincott Williams & Wilkins, Inc.