Mastectomy Research Today is a free monthly online journal that collates and summarizes the latest research about Mastectomy, including details on breast cancer, prosthesis, recovery, surgery, complications.

Excision only for tubular carcinoma of the breast.

Leonard CE, Howell K, Shapiro H, Ponce J, Kercher J

Rocky Mountain Cancer Centers, Radiation Oncology, Littleton, Colorado 80120, USA.

The purpose of this study was to assess the rationale of excision only (without breast irradiation) in patients with small (< or =3 cm) tubular/well-differentiated breast cancers. A total of 44 patients with pure tubular invasive breast cancer who have undergone complete excision only and have had a minimum 1-year follow-up were identified from the Colorado Cancer Registry and assessed for recurrence rates as well as median local disease-free and overall survival. Treatment dates were October 1972 to April 2001. The median age was 67 years (range 40-96 years). The median tumor size was 6.5 mm (range 2-30 mm). All patients had a complete excision with negative margins. Staging was as follows: T1N0 (11), T1Nx (27), T2N0 (1), T1N1 (3); 2 were unable to be staged accurately. After a median follow-up of 5.4 years (range 1.1-26.3 years) there were only two local recurrences in the ipsilateral breast (at 7.6 and 8.8 years), for a crude local control rate of 96% (2/44). Both patients were salvaged, are alive, and currently have no evidence of disease (NED) at last follow-up of 9 and 13.3 years. Actuarial 5- and 10-year local control rates were 100% and 87%. Actuarial 5- and 10-year overall and disease-free survivals were 80% and 52%, and 100% and 91%. Twenty-five patients had more than 5 years of follow-up. The median follow-up for this group was 9.1 years (range 5.1-26.3 years) and both recurrences were in this group. Although the number of cases in this report is small, it represents the largest total and longest follow-up for tubular breast cancer cases after excision alone. This report suggests that breast irradiation could be omitted after conservative surgery in older patients with smaller (< or =3 cm) tubular/well-differentiated breast cancers. However, due to the retrospective nature of our report, we cannot categorically make this recommendation.

Published 25 February 2005 in Breast J, 11(2): 129-33.
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