DOES PROPHYLACTIC RADIATION THERAPY GIVEN FOR CANCER OF THE BREAST PREDISPOSE TO METASTASIS?

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Abstract
The results of 674 clinic patients with primary cancer of the breast who had radical or extended radical mastectomies, with or without postoperative radiation therapy at Memorial Center, were analyzed. There were 205 patients who received postoperative irradiation and 469 who did not. Patients who received postoperative irradiation had more advanced disease as indicated by more frequent and more extensive axillary lymph node metastases. Survival rates of the patients with the same stage of disease were similar except that there was a statistically significant higher survival rate at the 5 year level for the irradiated patients who had metastases in the apical axillary lymph nodes. The incidence of lung, pleura and skin metastases was the same in the irradiated and nonirradiated patients who were compared according to their axillary lymph node status. There was a lower incidence of and a delay in the appearance of metastatic lymph nodes in the prophylactically irradiated supraclavicular fossa. Serious radiation complications consisting of chronic ulceration and/or radiation osteitis occurred in 10 of the 205 patients (5 percent) who received orthovoltage postoperative radiation therapy. Randomized studies with supervoltage equipment need to be done before the value of prophylactic radiation therapy for cancer of the breast can be accurately evaluated.

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