2049 Treatment of the axilla with radiation therapy (RT) without an axillary dissection (AD) in patients with invasive breast cancer

objective: To evaluate the therapeutic efficacy of RT to the axilla without AD in the management of patients with invasive breast cancer. Materials and Methods: From 1962 to 1994 data on 550 breast cancers in 537 patients (13 had bilateral cancer) were reviewed. All patients underwent lumpectomy without AD followed by RT to tbe breast and regional nodes including the axilla. Age ranged thorn 23 92 years (median 63 years). All cancers were histologically proven to be invasive and 91% had infiltrating duct cell cancer. The median T-size was 2 cm; 61 % had T1,35.8% bad T2 and 3.2 % had T3 lesions. Fifty seven axillae (10%) had palpable adenopathy and 493 (90%) were clinically NO. Megavoltage beam was used in all cases. The axilla was treated with an anterior tield + posterior axilla boost field. The median RT dose to the NO axilla was 50 Gy and 59 Gy to the axilla with palpable disease. Majority (76 %) of the patients did not receive adjuvant systemic or hormone therapy. Results: The median follow up is 74 months (range: 12 to 246). The recurrence rates in the axilla were as follows: