234
Abstracts / 2nd International Syniposyum oil Organ Sparing Treahneni	234
Breast sparing treatment of mammary cancer
Alexandru Blidaru, Cristian loan Bordea, Cristian Viisoreanu, Ion Balanescu
Institute of Oncology „Prof.Dr. Al. Trestioreanu" Bucharest, Romania
Background. Conservative treatment ofbreast cancer is a valid alternative to mastectomy in the early stage ofthe disease. The purpose ofthe paper is to establish the subgroups of patients best suited far this type of therapy and the optimum therapeutic protocol.
Patients and methods. This is a prospective study that overviews the outcome offour groups of patients with stage I and II ofbreast cancer treated by the same medical team at the Bucharest Oncologjcal Institute: Group A: 123 patients who underwent conservative treatment as they met the selection criteria far this type of therapy;
•	Group Bl: 30 patients who underwent conservative treatment because they had refused mastectomy;
' Group B2: 40 patients who underwent conservative treahnent because of medical contmndication far extended surgery;
•	Group M: 150 patients by whom mastectomy was performed, although they would have fulfilled the selection criteria far conservative h-eatrnent
The most important selection criteria far conservative treatment were: unilateral, unicentiic breast cancer, T<2.5cm, N0-N1, tumor/breast ratio that would allow proper excision with a convenient cosmetic outcome, and patient's wish.
Surgery far the primary himor consisted of limited mammary resection, defined as excision of the tumor together with at least 2 cm of peritumoural mammary tissue. The amplitude ofmammary resection depended on the location, size and histopathological type of the tumor and on the breast size. Axillary dissection was performed far diagnostic purposes and far local control of the axillary disease. Post-operative radiotherapy is an essential component of conservative treatment targeting the mammary gland and, under certain circumstances, the regional ganglionar areas. Chemotherapy and/or hormonal therapy were applied depending on the prognostic factors ofthe disease.
Results. Local recurrence rates at 5 years were 6.9% in Group A, 25% in Group Bl, 12.5% in Group B2, 1.3% in Group M. Overall survival rate at 5 years was 91.37% in Group A, 70.83% in Group Bl, 62.50% in Group B2, 88.60% in Group M. The cosmetic result of conservative treatment was good in over 70% of the cases.
Conclusion. Results confirmed that conservative therapy, with due observance of selection criteria and of the therapeutical protocol, is an appropriate therapy far a category of patients with early breast cancer.
Correspondence to: Alexandru Blidaru, M.D., Ph.D., Institute of Oncology Bucharest, Sos. Fundeni No. 252, Sector 2, Bucharest, Romania. Phone: 0040 1 650 72 81; Fax: 0040 1 232 60 12; E-mail: bordea@rnc.ro
Radiol Oiicol 2000; 34(3): 223-49.