Purpose
The combination of conservative surgery and radiotherapy is currently accepted as the preferred treatment for most patents with clinical stage I or II breast cancer. However, there is large amount of controversy concerning the optimal means of
selecting
patients and the details of the treatment technique. Breast cancer patients are being treated both in university hospitals and in community hospitals. Generally, the radiation therapy is not available in many community hospitals. Radiation
therapy,
which generally follows either a mastectomy or conservative surgery, is an important procedure. Therefore, the type of hospital facilities may influence which surgical procedures are selected. The authors conducted this study to analyse the
current
patterns of care for early invasive breast cancer in a hospital without a radiation therapy unit, even though the patient could receive such treatment from another affiliated hospital.
Methods
131 cases of stage I and II breast cancer patients were reviewed between 1987 and 1997, and the types of treatments including surgery, radiation therapy and systemic therapy, were analysed retrospectively.
Results
The surgical procedures used were mainly a modified radical mastectomy (124/131, 94.7%), followed by breast conservation surgery (4/131, 3.1%), a total mastectomy (2/131, 1.5%) and a radical mastectomy (1/131, 0.8%). Radiation therapy was applied
to 19
stage II patients (N=105), but not to any of the stage I patients (N=26). Systemic adjuvant therapy was done with chemotherapy (39/131, 29.8%), hormone therapy (17/131, 13.0%) and a combination of both modalities (67/131, 51.1%), with an
exception
of 8
cases.
Conclusion
Breast conservation therapy for breast cancer patients was underutilized. The selection of the therapeutic method may be influenced by the facilities of the particular hospital. For proper treatment of early stage breast cancer, a surgeon must
keep
in
close contact with bothe a radiologist and a radiotherapist, even in other affiliated hospitals.
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