Role of radiotherapy following total mastectomy in patients with early breast cancer

• Published in: World journal of surgery 1994-01, Vol.18 (1), p.117-122
• Main Authors: Houghton, J., Baum, M., Haybittle, J. L.
• Format: Article
• Language: English
• Subjects: Cardiac Death Rate; Como; Cual; Early Breast Cancer; Local Relapse
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/BF00348201

Between June 1970 and April 1975 the CRC (King's/Cambridge) Trial for early breast cancer randomized 2800 patients folowing mastectomy to immediate prophylactic radiotherapy (DXT group, n=1376) or control (WP group, n=1424). Although no difference in overall survival has been demonstrated, there is an increase in mortality in the irradiated patients from nonbreast cancer causes beyond 5 years. It is because of an increase in the number of deaths due to new nonbreast malignancies [RR=1.89 (1.18–3.05)] and to cardiac‐related disease [RR=1.52 (1.01–2.29)]. This increased cardiac death rate may be related to the use of orthovoltage, which has greater scatter. There was a significant increase in risk for those with left‐sided rather than right‐sided tumors in this subgroup [χ2(int) = 5.08; p = 0.02]. Local relapse was significantly reduced in those patients randomized to radiotherapy [RR=0.44 (0.39–0.51)]. Median survival following local relapse was 1.35 years in the DXT group and 2.66 years in the WP group (logrank p