In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .
Is surgery necessary after complete clinical remission following neoadjuvant chemotherapy for early breast cancer?
PURPOSE This retrospective analysis aim ed to identify whether breast cancer patients receiving radiotherapy alone following a complete clinical remission ( cCR ) to neoadjuvant chemotherapy had a worse outcome than those treated with surgery . PATIENTS AND METHODS One hundred thirty-six patients who had achieved a cCR to neoadjuvant chemotherapy for early breast cancer were identified from a prospect ively maintained data base of 453 patients . Of these , 67 patients had undergone surgery as their primary locoregional therapy , and 69 patients had radiotherapy alone . Outcome was assessed in relation to local recurrence-free survival , disease-free survival , and overall survival . RESULTS Median follow-up was 63 months in the surgery group and 87 months in the no surgery group . Prognostic characteristics were well balanced between the two groups . For surgery and no surgery , respectively , there were no significant differences in disease-free survival or overall survival ( 5-year , 74 % v 76 % ; 10-year , 60 % v 70 % , P = .9 ) between the two groups . There was a nonsignificant trend toward increased locoregional-only recurrence for the no surgery group ( 21 % v 10 % at 5 years ; P = .09 ) , but no long-term failures of local control . Patients in the no surgery group who also achieved an ultrasound complete remission had a 5-year local recurrence rate of only 8 % . CONCLUSION In patients achieving a cCR to neoadjuvant chemotherapy , radiotherapy alone achieve survival rates as good as with surgery , but with higher local recurrence rates . Ultrasound may identify a low recurrence rate subgroup for assessing no surgery in a prospect i ve trial
In patients with a de novo diagnosis of breast cancer with synchronous distant metastases , surgery and radiotherapy result in considerably better locoregional tumor control .
An improvement in survival has not been consistently proven , but may exist in subgroups of patients .
Bei Patientinnen mit primärer Fernmetastasierung führt die lokale Beh and lung mittels Operation und/oder Strahlentherapie zur besseren lokalen Tumorkontrolle .
Aim The purpose of this work is to give practical guidelines for radiotherapy of locally advanced , inflammatory and metastatic breast cancer at first presentation .
ZusammenfassungZielZiel der Arbeit ist die Entwicklung von Praxis-Leitlinien zur Strahlentherapie des lokal fortgeschrittenen einschließlich des inflammatorischen Mammakarzinoms sowie zur lokalen Therapie bei synchroner Fernmetastasierung .
Ein Überlebensvorteil besteht wohl nicht , möglicherweise aber doch für einige Subgruppen der Patientinnen .