Our experience in breast conserving surgery in breast cancers

Abstract

Objective: This study presents the long-term results of patients who had breast conserving surgery at our clinic because of breast cancer. Methods: The data of 99 patients, who had breast conserving surgery because of breast cancer between January 2005 and December 2013 at Necmettin Erbakan University, Meram Medical School\'s Department of General Surgery, were retrospectively evaluated. The analyses of the study were conducted by the SPSS 21.0 program. Results: The total number of patients was 99 and the mean age was 51.11 ± 9.62 (31-74). The most frequently seen pathology was infiltrative ductal carcinoma and it was detected in 62 (62.6%) patients. 88.7% (87 cases) of the cases received adjuvant radiotherapy in the post-op period. Following the mean follow-up period of 38.86 ± 23.43 (5-92) months, only one patient passed away. Further, 1 patient underwent surgery again after having local recurrence 70 months later and 3 patients also underwent surgery again upon detecting that they had tumors on the surgical border. Conclusion: After obtaining acceptable oncological results, the fundamental approach in the surgical treatment of breast cancers is to select the method that will have the least negative effect on the patient\'s quality of life. At this point, selecting breast conserving surgery over radical surgical methods is an appropriate approach for suitable patients chosen carefully.

Keywords

• Breast cancer, breast conserving surgery, radical mastectomy

Meme kanserlerinde meme koruyucu cerrahi deneyimimiz

Abstract

Amaç: Bu çalışmada kliniğimizde meme kanseri nedeni ile meme koruyucu cerrahi uygulanmış olan hastaların uzun dönem sonuçları sunulmuştur. Yöntemler: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Genel Cerrahi anabilim dalında Ocak 2005 ve Aralık 2013 tarihleri arasında meme kanseri nedeni ile meme koruyucu cerrahi uygulanan 99 hastanın verileri geriye dönük olarak incelenmiştir. Çalışmamıza ait analizler SPSS 21,0 paket programı kullanılarak yapıldı. Bulgular: Toplam hasta sayısı 99 ve yaş ortalaması 51.11 ± 9,62 (31-74)idi. En sık görülen patoloji infiltratif duktal karsinom idi (62 (%62,6) hastada). Vakaların %88,7 (87 olgu) sine operasyon sonrası adjuvan radyoterapi uygulandı. Ortalama 38,86 ± 23,43 (5-92) aylık takipler sonrasında sadece 1 hasta yaşamını yitirmiştir. 1 hasta operasyondan 70 ay sonra gelişe lokal nüks ve 3 hasta cerrahi sınırda tümör tespit edilmesi nedeni ile yeniden opere edildi. Sonuç: Meme kanserinin cerrahi tedavisindeki temel yaklaşım kabul edilebilir onkolojik sonuçlar sağladıktan sonra hastanın yaşam kalitesini en az etkileyecek yöntemi seçmektir. Bu noktada meme koruyucu cerrahinin doğru seçilmiş hastalarda radikal cerrahi yöntemler yerine tercih edilmesi uygun bir yaklaşımdır.

Keywords

• Meme kanseri, meme koruyucu cerrahi, radikal mastektomi

References

1. NIH consensus conference. Treatment of early-stage breast cancer. JAMA 1991;265:391-3955.
2. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow up of a randomized trial comparing total mastectomy, lumpec- tomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 2002;347:1233-1241.
3. Liljegren G. Holmberg J. Bergh A, et al. 10-year results after sector resection with or without postoperative radiotherapy for stage 1 breast cancer: A randomized trial. J Clin Oncol 1999; 17:2326-2333.
4. Rabinovitch R, Kavanagh B. Double Helix of breast cancer therapy: intertwining the Halsted and Fisher hypotheses. J Clin Oncol 2009;27:2422-2423.
5. Kement M, Gezen C, Aşık A, et al. Breast conserving surgery and modified radical mastectomy in Turkish women with breast cancer: a prospective analysis of quality of life. Tur- kiye Klinikleri J Med Sci 2011;31:1377-1384.
6. Haydaroğlu A, Özsaran A, Akagündüz Ö, ve ark. Meme ko- ruyucu cerrahi ve radyoterapi uygulanan erken evre meme kanserlerinde lokal kontrol ve sağ kalımı etkileyen prog- nostik faktörler. Meme Sağlığı Dergisi 2006;2:71-76.
7. Lazovich D, Solomon CC, Thomas DB, et al. Breast conser- vation therapy in the United States following the 1990 Na- tional Institutes of Health Consensus Development Confer- ence on the treatment of patients with early stage invasive breast carcinoma. Cancer. 1999;86:628-637.
8. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an over- view of the randomised trials. Lancet 2005;366:2087-2106.

9. Fisher B, Dignam J, Wolmark N, et al. Lumpectomy and ra- diation therapy for the treatment of intraductal breast can- cer: Findings from National Surgical Adjuvant Breast and Bowel Project B-17. J Clin Oncol 1998;16: 441-452.
10. Zucali R, Merson M, Placucci M, et al. Soft-tissue sarcoma of the breast after conservative surgery and irradiation for early breast mammary cancer. Radiother Oncol 1994; 30: 271-273.
11. Patani N, Cutuli B, Mokbel K. Current management of DCIS: a review. Breast cancer Res Treat 2008; 111: 1-10
12. Kestin LL, Goldstein NS, Martinez AA, et al. Mammo- graphically detected ductal carcinoma in situ treated with conservative surgery with or without radiation therapy: pat- terns of failure and 10 year results. Ann Surg 2000; 231: 235–245.
13. Vargas C, Kestin L, Go N, et al. Factors associated with lo- cal recurrence and cause spesifi c survival in patients with ductal carcinoma in situ of the breast treated with breast- conserving therapy or mastectomy. Int J Radiat Oncol Biol Phys 2005; 63: 1514–21.
14. Slotman BJ, Meyer OW, Njo KH, Karim AB. Importance of timing of radiotherapy in breast conserving treatment for early stage breast cancer. Radiother Oncol 1994;30:206- 212.
15. Houssami N, Hayes DF. Review of preoperative magnetic resonance imaging (MRI) in breast cancer: Should MRI be performed on all women with newly diagnosed, early stage breast cancer? CA Cancer J Clin 2009;59:290-302.
16. Bleicher RJ, Ciocca RM, Egleston BL: Association of rou- tine pretreatment magnetic resonance imaging with time to surgery, mastectomy rate, and margin status. J Am Coll Surg 2009;209:180-187.
17. Solin LJ, Orel SG, Hwang WT: Relationship of breast mag- netic resonance imaging to outcome after breast-conserva- tion treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol 2008;26:386-1.
18. Zanapalıoğlu Y, Atahan K, Gür S, et al. effect of breast con- serving surgery ın quality of life in breast cancer patients. J Breast Health 2009:3:152-156.
19. Vass S, Bairati I. A cosmetic evaluation of breast cancer treatment: a randomized study of radiotherapy boost tech- nique. Int J Radiat Oncol Biol Phys 2005; 62: 1274–1272.
20. Huang CC, Lien HH, Tu SH, et al. Quality of life in Taiwan- ese breast cancer survivors with breast conserving therapy. Formos Med Assoc 2010;109:493-502.