%0 Journal Article
%T Regional radiotherapy versus an axillary lymph node dissection after lumpectomy: a safe alternative for an axillary lymph node dissection in a clinically uninvolved axilla in breast cancer. A case control study with 10 years follow up
%A Patty H Spruit
%A Sabine Siesling
%A Marloes AG Elferink
%A Ernest JA Vonk
%A Carel JM Hoekstra
%J Radiation Oncology
%D 2007
%I BioMed Central
%R 10.1186/1748-717x-2-40
%X Before the introduction of the sentinel node biopsy, we conducted a study in which 180 women of 50 years and older with T1/T2 cN0 breast cancer were treated with breast conserving therapy. Instead of an axillary lymph node dissection regional radiotherapy was given in combination with tamoxifen (RT-group). The study group was compared with 341 patients, with the same patient and tumour characteristics, treated with an axillary lymph node dissection (S-group).The treatment groups were comparable, except for age. The RT-group was significantly older than the S-group. The median follow up was 7.2 years. The regional relapse rates were low and equal in both treatment groups, 1.1% in RT-group versus 1.5% in S-group at 5 years. The overall survival was similar; the disease free survival was significant better in the RT-group.Regional recurrence rates after regional radiotherapy are very low and equal to an axillary lymphnode dissection.Before the introduction of the sentinel node biopsy, the standard treatment of the axilla in early stage breast cancer was an axillary lymph node dissection (ALND). An ALND results in a high risk of morbidity, while in 70% of the postmenopausal patients with early stage breast cancer an ALND would be unnecessary because of the absence of lymph node metastases [1-4]. Lymph oedema of the arm (2每28%) [4-6] and shoulder function impairment (5每19%) [4] are most debilitating but even more patients suffer from dysesthesia and pain (23每31%) [6-8].An alternative to an ALND is primary regional radiotherapy. This is expected to give less morbidity: arm oedema to a lesser extent (0每9%) and shoulder function impairment (0每1%) [4,9] are noted. Dysesthesia and pain are neither mentioned nor expected.It is always a challenge to find alternative treatments leading to less complaints but this may not lead to major changes in tumour control and survival rates.This study was initiated under the assumption that the control rates and survival after regional radi
%U http://www.ro-journal.com/content/2/1/40