It is now generally agreed that conservative surgery with radiation represents a valid alternative to mastectomy for treatment of stage I and II breast cancer. At present, seven prospective randomized trials have shown the equivalence of mastectomy versus conservative surgery and radiotherapy in terms of local recurrence, 5- and 10-year disease-free survival, and overall survival.1,2 Postoperative irradiation represents a fundamental component of conservative management and the NSABP-B6 study confirms the high incidence of breast cancer recurrence in patients undergoing wide excision without radiation, with 37% local recurrences in node-negative patients and 43% in node-positive patients. Instead, locoregional recurrence following conservative surgery and irradiation for early breast cancer ranges from 5% to 10% at 5 years and from 10% to 15% at 10 years.3 These figures are comparable to those achieved with mastectomy.
KeywordsFatigue Toxicity Cage Pneumonia Fractionation
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