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Volume 16, Number 6, 2011

Comparison of mastectomy with breast-conserving surgery in invasive lobular carcinoma: 15-Year results

János Fodor, Tibor Major, József Tóth, Zoltán Sulyok, Csaba Polgár


Background: Invasive lobular cancer (ILC) is biologically distinct from invasive ductal cancer
and there is disagreement regarding appropriate local management of this disease.
Aim: The current study reports long term results comparing mastectomy with breastconserving
surgery (BCS) in the treatment of ILC.
Material and methods: Study includes 235 women with ILC treated between 1983 and 1987.
All of them underwent axillary dissection and either mastectomy (n = 163) or BCS (n = 72).
50 Gy adjuvant radiotherapy (RT) was given for 53 BCS and 81 mastectomy patients. The BCS
group was compared with the mastectomy group.
Results: Patients treated with mastectomy or BCS had a similar outcome at 15 years with
regard to distant metastasis-free (62% vs. 70%; p, 0.2017) and breast cancer-specific (62% vs.
70%; p, 0.1728) survival. In the BCS group the actuarial rate of ipsilateral in breast recurrences
was 10% with and 53% without RT at 15 years (relative risk [RR], 0.10; p < 0.0001). In the
mastectomy group the actuarial rate of chestwall recurrenceswas 16% with and 13% without
RT at 15 years (RR, 1.45; p, 0.3965). Isolated ipsilateral in breast recurrence did not (RR, 1.73;
p, 0.2767) but isolated chest-wall recurrence did (RR, 2.65; p, 0.0089) adversely affect causespecific survival.
Conclusion: Breast cancer specific survival is not affected by the type of surgical treatment.
BCS and RT is a safe option to control local disease in patients with ILC.

Signature: Rep Pract Oncol Radiother, 2011; 16(6) : 227-231

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