An analysis of long term complications in breast cancer patients after conservative therapy

Abstract

Background

Breast conserving surgery followed by irradiation and subsequent systematic application of therapy has been recognized as an efficient method for the treatment of early breast cancer for many years. The results of conservative treatment show a relatively low percentage of local relapses and good cosmetic results

Aim

The aim of the paper was to analyse the frequency and intensity of late complications after conservative treatment in breast carcinoma patients.

Materials/Methods

A group of 67 patients with stage I and II breast carcinoma, according to the TNM classification, and who underwent conservative treatment in the Lower-Silesian Centre for Oncology between 1995 and 2001 were included in the study. All patients underwent irradiation of the breast after conservative treatment. In 93% the total dose was 50 Gy and in the remaining 7% the dose amounted to 46–48 Gy. The dose was around 10 Gy higher at the tumour site. Irradiation of the lymph nodes was applied in 25% of cases and chemotherapy was used in 40%. The occurrence and intensity of late complications were assessed at 3–6 monthly intervals. Complications included: lymphatic swelling of the ipsilateral upper limb, necrosis of the soft tissues, post-radiation pneumonia, lung fibrosis, post-radiation rib fractures, plexopathy, late skin reaction and telangiectasia. Intensity was assessed using our own 4 level scale.

Results

Level 2 complications were observed in 22% of the patients and Level 3 complications were seen in 6%. No Level 4 complications were observed. Lymphatic swelling of the ipsilateral upper limb was the most frequent complication and occurred in 22% of the patients. Level 2 and Level 3 swelling was observed in 14.5%. Level 2 and 3 late post-radiation reactions were observed in 9% of the patients. Telangiectasia within the boost area was observed in 4.5% of the patients and outside the boost area in 9%. No local recurrence of carcinoma was observed.

Conclusions

The results of conservative treatment of breast carcinoma patients show low intensification of complications.