Conservative treatment of invasive lobular breast cancer.

Purpose: To assess the efficacy of breast conserving surgery (BCS), followed by postoperative radiation treatment (RT), chemotherapy and/or hormonotherapy in patients with early invasive lobular breast cancer (ILC).
Patients and Methods: 48 patients with TNM stages I and II ILC of the breast were treated conservatively by BCS (quadrantectomy) and axillary dissection to levels I and II, followed by RT and adjuvant chemotherapy or hormonal treatment. In patients with pN0 the remaining breast with scar and chest were treated by RT, with a total radiation dose (TRD) of 50 Gy. In cases with pN1 the axilla was included to the described field with TRD 50 Gy. In patients with high risk factors (pT2, tumor necrosis, infiltration of the subcutaneous fat and of lymph and/or blood vessels) the tumor bed was boosted up to a TRD of 60 Gy. The 5 and 10- year cancer-specific and recurrence-free survival were calculated according to the Kaplan-Meyer life-table method.
Results: With a median observation period of 6.5 years (range 1.5-11.5 years) 2 (4.1%) patients developed local recurrence and 2 (4.1%) distant metastases. Ten-year cancer- specific and recurrence-free survival are 97% and 90%, respectively.
Conclusion: The obtained good treatment results proved that the conservative treatment strategy in cases with ILC of the breast is a correct therapeutic choice.