September 1992

Breast Conservation Management of Breast Tumors 4 cm or Larger

Author Affiliations

From the Department of Radiation Oncology, UCLA (Drs Khanna and Juillard); the Radiation Medical Group, San Diego, Calif (Dr Mark); the Department of Surgery, The Breast Center, Van Nuys, Calif (Dr Silverstein); the Western Tumor Medical Group, Van Nuys (Dr Lewinsky); and The John Wayne Cancer Institute at Saint John's Hospital, Santa Monica, Calif (Dr Giuliano).

Arch Surg. 1992;127(9):1038-1043. doi:10.1001/archsurg.1992.01420090042007

• Randomized studies of stage I and II breast cancer have shown that breast conservation treatment is equivalent to modified radical mastectomy in regard to local-regional control and survival. Little has been published on breast conservation for patients with large tumors. We analyzed 68 patients with tumors measuring 4 cm or larger (range, 4 to 12 cm) treated with breast-conserving surgery and radiation therapy. The median follow-up was 46 months; the mean tumor size was 5 cm. The 5-year actuarial localregional recurrence rate was 8.5%, and the overall survival and disease-free survival rates were 76% and 68%, respectively. We conclude that breast conservation treatment may be a reasonable alternative to mastectomy in patients with tumors 4 cm or larger without compromise in local-regional control or survival, while achieving acceptable cosmesis.

(Arch Surg. 1992;127:1038-1043)