Conservative surgery and radiation therapy for early stage breast cancer. Can large trial experiences be reproduced in a community hospital setting?

Conservative surgery and radiation therapy were used to treat 212 patients with AJC clinical Stage I or II breast carcinoma at the Baptist Hospital of Miami. All had lumpectomy and most axillary lymph node dissection, followed by breast irradiation to a dose of 45 Gy and a boost dose of 14 to 16 Gy to the surgical bed. Median follow-up was 55 months. The five-year actuarial local control and survival rates were 94% and 86% respectively. Eighty-six percent of the patients had excellent or good cosmetic results with minimal differences between the treated and untreated breasts. Treatment-related complications were minor and infrequent. These results appear comparable to retrospective reviews at major university centers and ongoing prospective randomized trials.