The management of breast carcinoma by primary radiotherapy at Mount Sinai Hospital from 1962--1979.

Two-hundred eight patients with carcinoma of the breast were treated with megavoltage irradiation as the primary method of local management at Mount Sinai Hospital between 1962--1979. The effects of treatment volume, technique, and other parameters are discussed for the Stage I and II patients, together with the importance of tumor size and nodal status in control of local disease and distant metastases. In this series the cumulative probability of freedom from metastases is 93 +/- 5% when the irradiation is confined to the breast and axilla as compared with 72 +/- 9% when extended fields are used, with no difference in local control. Based on these results it was decided to confine irradiation to the breast and axilla alone in the majority of early stage cancer patients. Recommendations are made for radiation techniques and dosages to optimize control of the disease, minimize complications, and facilitate systemic therapy in patients with positive nodes.