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 c0onservation 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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