Conservative treatment in breast cancer King Faisal Specialist hospital (KFSH)‎ experience

Abstract EN

Background : Breast saving surgery and radiation therapy have been established as an effective therapeutic approach for early breast cancer.

This method has produced local control rate equivalent to that following mastectomy with the additional benefit of breast preservation in the majority of patients.

We present the experience of KFSH in the management of 98 patients in the Kingdom of Saudi Arabia.

Methods : Ninety-eight female patients with reasonable Tumor / breast size ratio were treated by conservative surgery and radiotherapy with or without adjuvant chemohormonal therapy and were closely followed up.

Results : Between 1981 and 1990, 98 patients benefited from breast saving surgery.

Forty-nine patients (50 %) were below the age of 40.

The group included 15 T1, 52 T2, 29 T3 and 2 Tx tumors.

The 5-year overall survival and local control rates of the whole group was 79 ± 6 % and 88 ± 4 % respectively.

The lymph node (LN) status, site of the primary tumor, extent of surgery, dose of radiotherapy to the tumor bed, as well as the chemo-hormonal therapy were all studied as prognostic factors.

The only significant factor was the site of the primary tumor.

Patients with inner quadrant tumors had a 5-year local control rate of 74 ± 10 % compared to 90 ± 4 % for outer quadrant lesions (p = 0.01).

Conclusion : Conservative surgery and radiotherapy for relatively early breast cancer became an accepted therapeutic alternative in breast cancer therapy.

More attention has to be given by the therapy team to recruit more patients especially those with small outer quadrant tumors to benefit from this less morbid surgery.