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Breast conservation treatment in Hong Kong—early
results of 203 patients: retrospective study
TK Yau, Y Lau, J Kong, MW Yeung, M Chan, WM Sze, P Cheung, BH Lim,
A Lee
Department of Clinical Oncology, Pamela Youde Nethersole Eastern
Hospital, 3 Lok Man Road, Chai Wan, Hong Kong
OBJECTIVE. To study the clinical outcomes of patients
with invasive or non-invasive breast cancer after breast conservation
treatment.
DESIGN. Retrospective study.
SETTING. Clinical oncology department of a public hospital, Hong
Kong.
PATIENTS. Two hundred and three patients who received postlumpectomy
radiotherapy in Pamela Youde Nethersole Eastern Hospital between
January 1994 and June 1999.
INTERVENTIONS. Adjuvant radiotherapy with or without systemic adjuvant
treatment.
MAIN OUTCOME MEASURES. Actuarial local control rate, progression-free
survival rate, disease-specific survival rate, and cosmetic score.
RESULTS. The median follow-up of the whole group was 3.5 years.
Two out of the 25 patients with carcinoma-in-situ only developed
local recurrence; the 5-year actuarial local control rate was 91.3%.
Among the 178 patients with invasive cancer, seven suffered local
recurrence and 12 developed distant metastases without local failure.
The 5-year actuarial local control, progression-free survival, and
disease-specific survival rates for patients with invasive cancer
were 95.5%, 85.8%, and 95.2%, respectively. The risk of local recurrence
was significantly increased in younger patients (age <40 years)
and those with positive final margins. Cosmetic scores were rated
good to excellent by 95.6% of patients.
CONCLUSIONS. The early clinical outcomes of our patients are comparable
to that in large overseas trials, which have demonstrated the equivalence
of mastectomy and breast conservation treatment in terms of survival.
In addition to mastectomy, with or without breast reconstruction,
breast conservation treatment should be offered as an alternative
in suitable Chinese women. To maximise local control, further excision
or mastectomy is recommended for patients with positive final margins.
Hong Kong Med J 2002;8:322-8
Key words: Breast neoplasms; Mastectomy; Radiotherapy
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