IJSR - International Journal of Scientific Research

Dr. Samip M. Pansora; Dr. Meena Shah; Dr Nimisha Gajera

Volume : VIII, Issue : VIII, August - 2019

Patterns of failure in Locally advanced Breast Cancer treated with or without Radiotherapy

Dr. Samip M. Pansora, Dr. Meena Shah, Dr Nimisha Gajera

Abstract :

Background: The purpose of this study was to test the role of radiotherapy following modified radical mastectomy and adjuvant systemic therapy in the management of operable locally advanced east carcinoma. Materials and Method: After undergoing mastectomy and axillary dissection, 70 patients with locally advanced east carcinoma were registered for study. All patients were then treated with full course of chemotherapy. After being restaged, all patients remaining without recurrence were offered postmastectomy radiotherapy. Though radiotherapy was offered to all patients, nearly half of the patients refused for radiotherapy and preferred observation. For ER positive patients, adjuvant endocrine therapy was advised for 5 years. Results: Of 70 patients, 30 were deemed ineligible, leaving 40 cases eligible and analyzable. All the patients received planned adjuvant systemic chemotherapy. Out of these, 22 patients received Radiotherapy and 18 patients preferred Observation. Median follow–up period was 4 years. The loco–regional recurrence rate was 4.5% in radiation arm and 11% in observation arm. Of those in RT arm, 36.4% failed distantly with a median time to failure of 2 year. Of those in observation arm, 22.2% failed distantly, with a median time to failure of 3 years. When all sites at first failure were considered, there were fewer loco–regional recurrences in the RT arm but more of the RT patients had failed at 1 or more distant sites. Conclusion: Radiotherapy for locally advanced east carcinoma, following mastectomy, axillary dissection, and adjuvant systemic therapy, results in fewer locoregional but more distant recurrences at first failure. No significant advantage was seen for postmastectomy radiotherapy over observation in terms of either time to failure or survival. However, meaningful conclusions can’t be drawn as our study has limitations because of its retrospective character and small number of patients.