RESUMEN
BACKGROUND AND PURPOSE: In-breast tumor recurrence (IBTR) following lumpectomy and breast irradiation is usually managed by mastectomy. For women who refused mastectomy at the time of an IBTR, a repeat course of radiotherapy following repeat lumpectomy was offered. MATERIALS AND METHODS: Sixteen women with an IBTR following lumpectomy, axillary node dissection and breast irradiation were treated with repeat lumpectomy and radiotherapy to the operative area. Fifteen patients received 5000 cGy/25 fractions. One patient discontinued radiotherapy for non-medical reasons after having received only 3200 cGy/16 fractions. The interval from completion of the initial course of radiotherapy to documentation of IBTR varied from 10-130 months (median 31 months). RESULTS: Four patients (20%) have had further local failure. Ten of sixteen patients (62.5%) are alive and free or disease at 42-119 months from completion of the repeat course of radiotherapy. Of these latter patients, one had another in-breast tumor recurrence treated by excision alone and another had an in-breast tumor recurrence in the contra lateral breast post-lumpectomy and irradiation. Four patients died with distant metastasis, one is currently alive with contralateral breast cancer and distant metastasis, and one is alive with an extensive recurrence in the re-irradiated breast. Two of the patients with distant metastasis had abnormal bone scans at the time they received the repeat course of radiotherapy. There have been no severe late sequelae from the repeat course of radiotherapy. CONCLUSIONS: For selected patients, a repeat course of radiotherapy for an IBTR following lumpectomy and radiotherapy is well tolerated and may provide long-term local control.
Asunto(s)
Neoplasias de la Mama/radioterapia , Recurrencia Local de Neoplasia/radioterapia , Terapia Recuperativa , Adulto , Anciano , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Terapia Combinada , Supervivencia sin Enfermedad , Femenino , Humanos , Mastectomía Segmentaria , Persona de Mediana Edad , Pronóstico , Radioterapia de Alta Energía , Tasa de Supervivencia , Insuficiencia del TratamientoRESUMEN
A single subcutaneous injection of 10(7) live cells of the highly tumorigenic avian sarcoma virus (Schmidt-Ruppin strain, subgroup D)-transformed BALB/c line into BALB/c mice resulted in the production of an antiserum specific for the avian sarcoma virus gene product pp60src. All sera taken from mice 3 weeks after injection of tumor cells contained antibodies to pp60src. Immunoprecipitation experiments showed that all sera precipitated pp60src from Schmidt-Ruppin-infected chicken cells, but only a portion of these sera precipitated pp60src from chicken cells infected with other strains of avian sarcoma virus, i.e., Prague and Bratislava-77. Analysis of the cross-reactivity patterns of these antisera demonstrated a minimum of three to four antigenic determinants on pp60src. The findings reported here should facilitate the production of monoclonal antibodies to pp60src, which in turn will provide highly specific probes for further investigations into the structure and function of this protein.