Effect of delay in initiating radiotherapy for patients with early stage breast cancer

Aims: For early stage breast cancer, a standard treatment option is partial mastectomy followed by radiation treatment. The 5-year risk of local recurrence ranges from 6-9%. Variable waiting times for radiation treatment of breast cancer in our institution provided an opportunity to evaluate the impact of waiting time on the risk of local recurrence. Materials and methods: Between January 1988 and December 1989, 482 patients with stage I and I I breast cancer were treated with radiotherapy in our institution. Information on prognostic factors, such as age, tumour size, histological grade, number of positive lymph nodes and margins of resection, was abstracted from their charts. The interval between date of surgery and date of initial radiation treatment was noted. Dates of local recurrence, metastasis and deaths were recorded. Results: At 5 years, the local recurrence rate was 8%, the metastatic rate 12% and the 'cause-specific' survival rate 90%. In univariate analysis, the risk of local recurrence was associated with younger age, higher histological grade and time to radiation treatment. In the multivariate analysis, the effect of time to radiation treatment on the risk of local recurrence was equivocal. Conclusion: Delay in radiation treatment may be associated with an increased risk of local recurrence of breast cancer, at least in our centre. Future research is needed on a larger data set to more accurately estimate the effect of time to radiation treatment on the risk of local recurrence. (C) 2003 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.