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Objective: To evaluate the efficacy and prognostic factors of personalized treatment for breast cancer patients who failed chemotherapy., Methods: Seventy-two patients with breast cancer who failed chemotherapy were treated at the Tumor Hospital of Harbin Medical University from January 2001 to January 2012. Among them, 42 cases received 5.6 cycles (range, 4-8 cycles) of postoperative adjuvant chemotherapy, and 30 cases received 12.2 cycles (range, 6-22 cycles), both postoperative adjuvant and salvage chemotherapy. All of the 72 patients of stage IV were given personalized treatment. Under guidance of the principle that multidisciplinary treatment improves control rate but does not or less damage the normal tissues and host immune function, precise radiotherapy combined with Chinese herbal medicine (CHM), biological agent and others were chosen for the patients., Results: The median survival time was 20 months. Univariate analysis showed that non-invasive ductal carcinoma, less metastasized organs, without brain, liver and lung metastasis, Karnofsky performance scores ≥ 80, not combined with chemotherapy, and multiple courses of Chinese herbal medicine and biolojical agent treatment had significant impact on survival (P < 0.05). Multivariate analysis showed that no brain metastasis, non-invasive ductal carcinoma, and Chinese herbal medicine and biological agent treatment ≥ 7 courses and not combined with chemotherapy had obvious significance (P < 0.05). The rate of grade 3 and 4 treatment-related hematological toxicity was 8.3% (6/72) and 5.6% (4/72), respectively. All the patients with grade 4 hematological toxicity were the cases of grade 3 at hospital admission. No grade 3 and 4 acute radiation damages of the lung and liver were noticed., Conclusion: Chinese herbal medicine combined with biological agents and others prolongs survival time in breast cancer patients who failed chemotherapy, and provides an alternative treatment modality for them.

Objective: To explore the clinical feasibility of accelerated partial breast irradiation (APBI) by intensity-modulated radiotherapy (IMRT)., Methods: Twenty-six patients with T1N0M0 breast cancer were enrolled into a prospective accelerated partial-breast IMRT protocol between January 2008 and January 2010. Inverse planning of IMRT was employed at a prescribed dose of 34 Gy/10 f/5 d. Acute radiation skin responses and clinical effects were observed., Results: All of them completed radiation. During the radiation, Grade 1 of acute radiation skin reaction (mild hyperpigmentation) was seen in 8 patients and there was not > grade 2 of skin reaction. At Month 1 post-radiation, Grade 1 of acute radiation skin reaction (mild hyperpigmentation) was seen in all patients and there was not > grade 2 of skin reaction. At Month 3 post-radiation, all instances of acute radiation skin reactions recovered. The median follow-up period was 51 months (range: 35 - 59). The follow-up period of 23 patients were over 3 years. No local recurrences developed. The 3-year disease-free survival was 100%. Cosmesis was good or excellent in all cases at Year 2., Conclusion: External beam-partial breast irradiation delivered by IMRT is feasible for selected Chinese early-stage breast cancer patients after breast-conserving surgery. The cosmetic effect, local control rate and long-term survival rate are satisfactory. And acute radiation toxicity is quite low.

Objective: To explore the dosimetric variance in forward intensity modulated radiotherapy (IMRT) based on 4D CT and 3D CT after breast conserving surgery., Methods: Seventeen patients after breast conserving surgery underwent 3D CT simulation scans followed by respiration-synchronized 4D CT simulation scans at free breathing state. The treatment plan constructed using the end inspiration (EI) scan was then copied and applied to the end expiration (EE), and 3D scans and dose distribution were calculated separately. Dose-volume histograms (DVHs) parameters for the CTV, PTV, ipsilateral lung and heart were evaluated and compared., Results: The CTV volume difference was biggest between T0 and 3D CT, and the volume difference was 4.10 cm(3). Mean dose of PTV at EE was lower than that at EI (P = 0.019), but there were no statistically significant difference between 3D and EI, EE (all P > 0.05). The homogeneity index (HI) at EI, EE, 3D plans were 0.149, 0.159 and 0.164, respectively, and a significant difference was only between EI and EE (P = 0.039). The highest conformal index (CI) was at EI phase (P < 0.05), and there was no significant difference between EE and 3D (P = 0.758). The V(40) and V(50) of ipsilateral lung at EE phase were lower than that at EI (P < 0.05). There were no significant differences in all the indexes for heart (P > 0.05)., Conclusions: The breast deformation during respiration may be disregarded in whole breast IMRT. PTV dose distribution is significantly changed between EI and EE phases, and the differentiation of the lung high dose area between EI and EE phases may be induced by thorax expansion. 3D treatment planning is sufficient for whole breast forward IMRT, but 4D CT scans assisted by respiratory gating ensures more precise delivery of radiation dose.

Objective: Triple-negative [estrogen receptor (ER)-/progesterone receptor (PR)-/HER2-] breast cancer (TNBC) accounts for ∼ 15% of overall breast cancer and associated with a poor prognosis. There is a short of standard adjuvant chemotherapy regimens for TNBC. A number of studies have shown that TNBC might be sensitive to cisplatin and carboplatin on the basis that dysfunction of BRCA1 and its pathway is associated with a specific DNA-repair defect, but data of adjuvant setting about this is limited., Methods: From January 2010 to September 2011, 95 early triple-negative breast cancer patients confirmed by pathology were randomly assigned to receive TP (docetaxel 75 mg/m², carboplatin AUC = 5, day 1, 21 days a cycle for 6 cycles) or EC-T (epirubicin 90 mg/m², cyclophosphamide 600 mg/m², d1, 21 days a cycle for 4 cycles, followed by docetaxel 80 mg/m², d1, 21 days a cycle for 4 cycles) chemotherapy. Adjuvant radiation therapy was given selectively after chemotherapy. Here we report a preliminary safety analysis with the chi-square test., Results: Seventy-six out of the 95 patients had completed the chemotherapy and could be assessed for the safety profiles of the regimens. Thirty-seven of them were in the EC-T group with a median age of 47 years, and 21 out of these 37 patients were premenopausal (56.8%). Another 39 patients came from the TP group with a median age of 46 years, and 22 out of these 39 patients were premenopausal (56.4%). All of the 37 patients in EC-T group completed the planned treatment whereas 2 patients of the 39 cases in TP group did not because of bone marrow suppression. During the treatments, 9 patients had dose adjustment in each group. Adverse events of grade 1/2 were common. Specific incidence of adverse events with grade 3/4 in each group was as follows: alopecia, 29.7% vs. 10.3% (P = 0.033), vomiting 21.6% vs. 7.7% (P = 0.085), leukopenia 54.1% vs.25.6% (P = 0.011) and neutropenia 51.4% vs. 35.9% (P = 0.174). Other grade 3/4 toxicities were rare. All the adverse events (except peripheral neuropathy and pigmentation) recovered within 1 month after the chemotherapy., Conclusion: Both EC-T and TP regimens as adjuvant chemotherapy are safe and tolerable for the treatment of triple-negative breast cancer patients, while the TP regimen has advantages with less grade III/IV alopecia and leukopenia.

Objective: Endobronchial metastases (EBM) secondary to extrapulmonary solid malignant tumors are rare but may occur. The most common extrathoracic malignancies associated with EBM are colorectal, renal and breast cancer. This study aimed to evaluate the clinicopathological aspects of EBM from breast cancer and the prognosis of the patients., Methods: Clinicopathological data of 11 cases diagnosed as EBM from breast cancer treated in our hospital from 2003 to 2010 were re-evaluated. Their symptoms, recurrence interval, radiological features, histopathological properties, and prognosis were assessed., Results: Eleven cases were diagnosed by bronchoscopic bronchial biopsy. The median interval from diagnosis of breast cancer was 57 months (range: 11 - 189 mo). All patients had other proven metastases when the EBM was diagnosed. The most frequently observed symptoms were cough (8 cases). Interestingly, two patients were asymptomatic. Hilar mass (5 cases) was a common radiological finding. No disaccordance between the hormone receptor status in the primary and metastatic lesions in these patients was found. The median survival after EBM diagnosis was 21 months (range: 6 - 36) with four patients still alive and one of these four patients was surviving more than 7 years., Conclusions: On average, EBM is diagnosed about 5 years after the diagnosis of breast cancer, which is a relatively long lead time, but the median survival time is short, as 21 months in our group. The treatment plan must be individualized, because in some cases, long-term survival can be expected.

Objective: Breast conserving surgery (BCS) is one of standard treatment approaches in early breast cancer. Although most defect after BCS can be repaired, the cosmetic outcomes are unsatisfactory in the patients with poor tumor/breast ratio. Oncoplastic surgery (OPS) has emerged as a new approach for providing adequate tumor resection without compromise of aesthetic outcomes in BCS. Our purpose is to explore the cosmetic outcomes of applying latissimus dorsi (LD) muscle flap to reshape severe breast conservation deformities in breast cancer., Methods: Totally 24 cases of breast cancer were studied. The tumor size was 3.0 - 5.5 cm (median 3.5 cm). All the cases underwent BCS and achieved negative margin by frozen sections examination. Then LD flap reshaping were performed. All the patients received whole breast radiotherapy ± chemotherapy ± endocrine therapy., Results: All the LD flaps were alive without skin necrosis. After a median 23-month follow-up, all the cases were disease-free surviving. The whole breast radiotherapy had no significant effect on the LD flaps. The rate of good cosmetic results was 79.2%. The subjective satisfactory rate of the patients was 96%., Conclusions: Both satisfactory aesthetic outcome and good treatment effect were obtained using LD flap to reshape severe breast conservation deformity. OPS offers tools for breast conservation in patients otherwise destined for mastectomy or poor aesthetic outcome, such as large tumor/breast ratio, nipple-areola complex tumor, ductal carcinoma in situ, neoadjuvant chemotherapy cases and so on.

Objective: To analyze the role of postmastectomy radiotherapy (PMRT) in moderate- and high-risk elderly breast cancer patients., Methods: The clinicopathological data of 874 breast cancer patients treated with mastectomy and axillary dissection were retrospectively analyzed. The T1-2N1 patients were defined as moderate- risk (IR) group, and T3-4 and/or N2-3 cases as high-risk (HR) group. The locoregional recurrence (LRR) and overall survival (OS) rates were calculated and compared according to different age groups and radiotherapy status. Kaplan-Meier method and Log-rank test was used for calculation and comparison of the survival curves of different patient groups., Results: The median follow up time was 47 months. 108 (12.4%) patients were > or = 65 years. For patients who were < 65 and > or = 65 years, 18.1% and 15.3% received PMRT in the IR group, and 82.7% and 52.2% received PMRT in the HR group, respectively. For patients > or = 65 years, the 5-year LRR rates were 0% and 14.2% (P = 0.242) and 5-year OS rates were 100% and 75.2% (P = 0.159) for the PMRT-IR and non-PMRT-IR groups, respectively. The 5-year LRR rates were 0% and 14.1% (P = 0.061), 5-year OS rates were 84.6% and 77.4% (P = 0.597) for the PMRT-HR and non-PMRT-HR groups, respectively. For patients < 65 years, the 5-year LRR rates were 0% and 9.9% (P = 0.035) and 5-year OS rates were 87.0% and 82.1% (P = 0.739) for the PMRT-IR and non-PMRT-groups, respectively. The 5-year LRR rates were 7.2% and 26.1% (P = 0.000), 5-year OS rates were 79.2% and 57.7% (P = 0.000) for the PMRT-HR and non-PMRT-HR groups, respectively., Conclusion: With the increasing of age, there is a trend of decreasing use of postmastectomy radiotherapy in high-risk breast cancer patients. Postmastectomy radiotherapy can improve the locoregional control for high-risk patients and maybe considered even for those who are > or = 65 years.

Objective: To explore the influence of intrafraction and interfraction target displacement on the dose distribution in the target of forward whole-breast intensity-modulated radiotherapy (IMRT) assisted by active breathing control (ABC)., Methods: Each of the selected patient who had received breast conserving surgery was immobilized and received the primary CT simulation assisted by ABC device to get five sets of CT images in three different breathing status, including free breathing (FB) (one set), moderate deep inspiration breathing hold (mDIBH)(two sets) and deep expiration breathing hold (DEBH) (2 sets). After 10 to 15 fractions of radiation, the repeated CT simulation was completed and the same five sets of CT images were obtained at FB, mDIBH, and DEBH, respectively. In the Pinnacle3 treatment planning system, the forward IMRT planning was completed on the first set of mDIBH CT images from the primary CT simulation, and the planning was separately copied by the special system order to the second set of CT images from the primary CT simulation and to the first set of CT images from the repeated CT simulation, keeping the primary angle, direction, size and shape of the MLC field and prescribed dose un-changed. the volumes covered by selected high dose area in the selected segment were compared., Results: In the planning based on the first set of mDIBH CT images from the primary CT simulation, the volume irradiated by equal and more than 103% of prescribed dose in the segment was (1.16 +/- 0.39) cm3, and the volumes were (3.88 +/- 1.07) cm3 and (51.66 +/- 8.68) cm3 in the plannings copied from the first set of mDIBH CT images from the primary CT simulation respectively to the second set of CT images from the primary CT simulation and first set of CT images from the repeat CT simulation, the difference of the volume in the two plannings based on the two set mDIBH CT image from the primary CT simulation was not statistically significant (t = -1.672, P = 0.103). The difference of the volume in the two plannings based on the two sets of mDIBH CT images respectively from the primary and repeat CT simulations had a significant difference (t = -5.728, P < 0.01)., Conclusion: If the same threshold of mDIBH is maintained during IMRT after breast conserving surgery, the influence of the intrafraction target displacement on the dose distribution is not significant. However, if set-up error is not adjusted, the interfraction change of position of the segment given to cover the high dose area in the IMRT planning will be significant, resulting in a significant change of dose distribution in the breast.

Background and Objective: For early stage breast cancer with less than four metastatic axillary lymph nodes (ALN), indications for adjuvant radiotherapy are not well defined. This study was to investigate the risk factors for postmastectomy locoregional recurrence and survival in those patients., Methods: In total 217 patients undergoing mastectomy in Sun Yat-sen University Cancer Center between March 1998 and March 2002 were retrospectively reviewed. Seventy-one patients were at pT1 stage, and 146 cases at pT2 stage. Two hundred and two patients received adjuvant chemotherapy, 51 received radiotherapy (RT), and 116 received endocrine therapy whose estrogen receptors (ER) or progesterone receptors (PR) were positive., Results: The median follow-up time for these patients was 69 months. The 5-year actuarial locoregional recurrence-free survival (LRFS), disease-free survival (DFS), and overall survival (OS) were 85.2%, 81.8%, and 90.2%, respectively. Treatment failure was found in 44 patients, among whom 21 cases were diagnosed as locoregional recurrence. The 5-year actuarial OS was significantly lowered in patients with locoregional recurrence than in those without (61.9% vs. 93.6%, P<0.0001). Age younger than 35 years, pT2 tumor, and the rate of metastatic ALN>or=30% were risk factors for poor LRFS, DFS, and OS. When a scoring system was established consisting of these three prognostic factors, the 5-year actuarial LRFS in patients with varied scores were significantly different (P=0.0072). In the subgroup of 159 patients who received adjuvant chemotherapy of not less than five cycles, 35 patients who received adjuvant RT achieved significantly better survival rates than those who did not., Conclusion: Age younger than 35 years, pT2 tumor, and the rate of metastatic ALN>or=30% are risk factors for locoregional recurrence and survival in patients with early stage breast cancer who have one to three positive ALN. Adjuvant RT is recommended for those patients.

Objective: To explore the displacement of surgical clip and cavity during different respiratory status, intrafraction and interfraction for the patients treated by external-beam partial breast irradiation (EB-PBI) assisted by active breathing control (ABC) device after breast-conserving surgery., Methods: After breast-conserving surgery, twenty-five patients with stage I/II breast cancer who was identified to be feasible for EB-PBI underwent CT-simulation positioning assisted with ABC device. Five series of CT images were done during three respiratory status, which included one series of images during free breathing status (FB), two series of images during moderate deep inspiration breath hold (mDIBH), two series of images during deep expiration breath hold (DEBH) at 75% maximum inspiration capacity, and all of the five series of images were transferred to ADAC Pinnacle3 treatment planning system. This procedure was repeated after 10 - 15 days. The targets were delineated and the first appeared clips were marked by the same radiotherapist on the CT images in mDIBH and DEBH status from the first CT simulation positioning to analyze the displacement of the targets produced by respiratory status. The targets were also delineated and all of the clips were marked by the same radiotherapist on another two series of CT images during mDIBH from the first and repeated CT-simulation positioning for analyzing the intrafraction and interfraction movement of cavity and clips, respectively., Results: There was a significant difference between mDIBH and DEBH in the movement of the point of interest (POI) of the first appeared clip in the directions of X (0.22 cm), Y (1.27 cm) and Z axis (0.50 cm) (chi2 =9.558, P = 0.008); and this was also found to be present in the movement of POI of the cavity in the directions of X (0.10 cm), Y (1.08 cm) and Z axis (0.50 cm) (chi2 = 20.44, P <0.01). Regardless of the clip and the cavity, the movement extent along the direction of Y axis was the biggest. However, no significant difference was found in the displacements of POI of the geometric form constructed by all clips in the directions of X (0.09 cm, 0.68 cm), Y (0.14 cm, 0.37 cm) and Z axis (0.25 cm, 0.50 cm) in the same respiratory status of mDIBH at different moment in the intrafraction and interfraction, respectively; and this was also found in the displacements of POI of the cavity in the direction of X (0.15 cm, 0.66 cm), Y (0.17 cm, 0.45 cm) and Z axis (0.25 cm, 0.75 cm)in the same respiratory status of mDIBH at different moment in the intrafraction and interfraction, respectively., Conclusion: The margin of planning target volume for external beam partial breast irradiation in different respiratory status is found to be different, the margin displacement along the different axis is also different in free breathing status. However, it can be controlled almost at the same extent in moderate deep inspiration breath hold if assisted by active breathing control device.

Background & Objective: Breast-conserving therapy has become a widely accepted treatment option in the management of early-stage breast cancer. Postoperative radiotherapy is conventionally delivered with conventional wedged tangential fields. However, intensity modulation in radiotherapy helps to maximize tumor control while minimizing damage to normal tissues. This study was to evaluate the potential dosimetric benefits and optimal indications of intensity-modulated radiotherapy (IMRT) for the intact breast., Methods: Ten patients with stage Tis-2N0M0 breast cancer, who received breast-conserving surgery, were selected for this study. A dosimetric comparison of forward planning IMRT with conventional wedged tangential technique was performed on each patient using three-dimensional treatment planning. The total prescribed dose for both plans was 5000 cGy/25 fractions. Dose volume histograms (DVH) were used to compare the planning target volume (PTV) and organs at risks (OARs) such as ipsilateral lung, contralateral breast, contralateral lung for all patients, and coronary arteries, heart for left sided patients, and liver for right sided patients., Results: The PTV coverage in IMRT plan was similar to that of the conventional plan (97.7% vs. 98.3%). A better dose uniformity throughout the whole breast was achieved by IMRT plan. The percentage of PTV receiving less than 95% prescribed dose and more than 103% prescribed dose (inhomogeneity index, IHI) decreased from 29.9% to 2.9%; the percentage of PTV receiving more than 105% prescribed dose (V105%) decreased from 28.2% to 0.6%. A better amelioration of IHI and reduction of V105% in IMRT plans were observed in the relatively large PTV subgroup. Obvious reduction in the doses to OARs was achieved by IMRT plan. The maximum dose (D(max)) of coronary artery decreased from 5057.1 cGy to 4832.9 cGy, and the mean dose (D(mean)) of heart decreased from 629.8 cGy to 450.7 cGy; the Dmean of liver decreased from 283.9 cGy to 172.0 cGy for right sided patients; the Dmean and percentage of volume receiving more than 20 Gy (V20) of ipsilateral lung decreased from 925.2 cGy to 765.9 cGy, and from 16.0% to 15.3%, respectively; the Dmean and V20 of different central lung distance (CLD) subgroups decreased by 14.7% and 20.9%, 7.0% and 12.9%, respectively; the Dmean of contralateral breast decreased from 75.4 cGy to 20.3 cGy; the Dmean of contralateral lung decreased from 30.9 cGy to 16.1 cGy., Conclusion: Forward planning IMRT based on a standard tangential beam arrangement significantly improves the dose homogeneity throughout the target volume of intact breast, and reduces the dose to OARs, especially in patients with large breast volumes or exceeded CLD, who might be proposed as candidates of IMRT for intact breast.

Objective: The goal of the study is to investigate the feasibility of breast-conserving therapy for early primary breast carcinoma centrally located in the breast., Methods: 157 patients with stage I or II primary breast cancer located in the central part of the breast were operated with extended local excision and axillary lymph node dissection. Nipple-areola complex was excised in 18 patients. Ninety-three patients received two to six cycles neo-adjuvant chemotherapy. Radiotherapy was given postoperatively to the whole remaining breast., Results: The clinical response rate was 87.1% (81/93) and pathologic complete remission rate was 15.1% (14/93) after neo-adjuvant chemotherapy. Breast conservation surgery was performed successfully for all the patients in this series. After a median follow-up of 23 months (range 6-53 months), there was no recurrence in the ipsilateral breast. The aesthetic effect of the conserved breast was satisfactory including excellent for 88 patients and good for 48 patients representing of 86.6% of all cases., Conclusion: Breast conserving surgery is suitable for the early centrally located primary breast carcinoma. Though the short-term results are satisfactory, the long-term follow-up is still needed for the final outcome.

Objective: To compare the clinical curative effects between 89Sr and its combination with the Guliu recipe (GLR, a Chinese herbal medicine) in treating multiple bone metastatic tumor of mammary cancer (MBM-MC)., Methods: By adopting the random sampling and grouping method, 89Sr alone (Sr) and 89Sr combined with CHM (Sr-GLR) were used in treating 86 and 40 patients with MBM-MC respectively. The efficacy of therapy were appraised according to the degree of ostalgia relieving and quality of life (QOF) in patients, and the effect of treatment on focal bone metabolism and bone marrow hematopoietic function were compared., Results: The effective rate of Sr and Sr-GLR in relieving ostalgia was 83.72% and 95.00%, respectively (P > 0.05), the QOF improving and stabilizing rate of them 80.23% and 95.00% (P < 0.05), the effective rate on focal bone metabolism 59.30% and 52.50% (P > 0.05) and their hemo-toxicity 28.00% and 30.00% (P > 0.05)., Conclusion: Sr-GLR is a combination therapy in treating MBM-MC with good effect, it could raise the patient's QOF, enhance the ostalgia relieving effect without increasing the hemo-toxicity of treatment.

Background and Objective: Occult breast cancer is a kind of specific seldom clinically seen breast cancer. This study was designed to investigate the diagnosis and treatment of the patients with breast cancer., Methods: Retrospective study was conducted in 7 cases of occult breast cancer from May 1990 to May 2001., Results: All cases were female and account for 0.59% of the total breast cancer treated in the same period. Axillary node enlargement was presented as first sign and no breast mass was palpable in physical examination. Fine needle aspiration or excisional biopsy revealed metastatic adenocarcinoma before surgery. All cases were taken mammography and 1 case was suspicious of malignancy. 3 cases were taken ultrasonography and 1 case was suspicious of malignancy. 5 cases underwent radical mastectomy and 2 cases underwent modified radical mastectomy. Pathological examination of the removed specimen found the primary breast cancer leison in 4 case and showed infiltrative carcinoma in 3 cases and intraductal carcinoma in 1 case. After surgery, 2 cases received radiotherapy plus chemotherapy, 5 case received chemotherapy and 4 case received tamoxifen therapy. All case were still alive and 3 cases survived over 54 months and 1 case survived for 7 years., Conclusion: Occult breast cancer should be considered when axillary lymph node is enlarged in female. Fine needle aspiration and excisional biopsy are helpful in pathologic diagnosis preoperatively. Mammography and ultrasonography have low sensitivity in identifying primary tumor. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable choice for the patients with occult breast cancer and the prognosis is superior or similar to those patients who with palpable mass both in breast and axillary.

68 Cases of early breast cancer were divided into local resection group (33 cases) and local resection plus axillary dissection group (35 cases). The 3-, 5- and 10-year survival rate of the two groups were 97.0%, 78.8%, 72.7% and 94.3%, 80.0%, 77.1% respectively; The metastasis rate of the two groups were 6.1%, 12.1%, 3.0% and 8.6%, 17.1%, 8.6% respectively; and the local recurrence rate of the two groups were 6.1%, 6.1%, 3.0%, and 5.7%, 5.7%, 2.9% respectively ( P > 0.05). The cosmetic satisfaction rate of the two groups were 60.6% and 65.7% respectively ( P > 0.05). Factors relating to cosmetic results were type of breast, operative incision, age and postoperative radiotherapy. Conservative operation for early breast cancer was safe, provided incision margin was 2 cm approximately 3 cm. In all patients mammplasty was performed after tumor resection, and contralateral breast were treated by mammominification when it was necessary.

Forty-five patients with breast cancer were treated in our hospital by conservative surgery and radiation therapy from 1985 to 1994. There were 22 patients in stage I and 23 in stage II. All the patients were received breast-preserved operation including segmental resection and axillary node dissection. Routine postoperative irradiation was given to the patients with or without regional lymphatic melastasis. The indications of chemotherapy and endocrinotherapy were as same as those of Halsted's radical mastectomy. The duration of following-up was 3-5 years. The 5-year local recurrence was 8.8%. The 5-year OS was 94.1%, and DFS 94.1%.