Primaire bestraling van de oksel na borstsparende chirurgie wegens borstkanker: gunstige effectiviteit bij beperkte complicaties

The objective of this study was to evaluate the effectiveness and morbidity of primary axillary radiotherapy in breast-conserving therapy for clinically axillary lymph node negative patients with early stage breast carcinoma.

Design

Retrospective.

Method

105 patients with T1-2 breast cancer without palpatory metastases in the axillary lymph nodes and mostly postmenopausal were treated with breast-conserving therapy, including irradiation of the axilla, 1983/'97 in the Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital in Amsterdam. Adjuvant treatment with tamoxifen was given to 75 patients. Development of recurrences was examined by the treating physician. Seventy-four of the 92 surviving patients without recurrences and in good physical condition were asked about late complications, edema and arm function restriction; the latter two parameters were also measured during a physical examination (response: n = 55). The median follow-up of 92 patients still alive was 41 months (range: 8-137).

Results

The mean age of the 105 patients at the time of irradiation was 64 years. Three patients developed a local recurrence. Axillary recurrences were found in two patients who also had distant metastases. In the examined 55 patients, arm edema was reported by 4 and measured in 11, whereas impaired shoulder function was reported in 35 and measured in 17. There was no brachial plexus neuropathy.

Conclusion

Primary axillary radiotherapy for selected patients with clinically lymph node negative breast carcinoma was found to result in low axillary recurrence rates and limited morbidity.