男性乳腺癌9例报告

目的 报告9例男性乳腺癌患者的临床表现、治疗效果和预后情况。方法 5例行根治术，1例行局部切除 腋窝清扫术，5例腋窝淋巴结转移(74．1％)，术后3例进行了正规辅助治疗。结果5年生存率44．4％。均为Ⅰ期、II期。结论男性乳腺癌预后与临床分期、腋窝淋巴结状况有关。以手术治疗为主，同时辅助放疗、化疗、内分泌等综合治疗，以期提高疗效。     

23例男性乳腺癌临床分析

目的　探讨男性乳腺癌的临床特点与预后。方法　分析我院 1986年 8月至 1999年 12月期间收治的 2 3例男性乳腺癌。结果　该病占同期乳腺癌的 1 2 5 % ,Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为 2例、10例、8例、3例 ,以浸润性导管癌为主 ,腋窝淋巴结转移率 5 6 5 % ,ER、PR受体阳性占 75 % ,5年、10年生存率分别为 61 5 %、2 5 0 % ,Ⅰ～Ⅱ期、腋淋巴结阴性组 5年、10年生存率明显高于Ⅲ～Ⅳ、腋淋巴结阳性组。结论　男性乳腺癌是一种少见恶性肿瘤 ,临床分期、腋淋巴结转移情况是重要的预后指标。以根治术为主辅以放疗、化疗、内分泌治疗是男性乳腺癌的较理想治疗方法     

Ⅰ期、Ⅱ期乳腺癌术后局部复发的放疗及预后

目的：探讨乳腺癌术后局部区域复发的规律和再放疗的预后。方法：回顾分析45例Ⅰ期、Ⅱ期乳腺癌术后局部区域复发的情况以及复发后放疗的预后。26例采用局部野放疗，19例采用扩大野放疗。结果：T2及腋窝淋巴结转移数≥4枚或≥20％的病例占复发病例的73％。复发的部位依次为锁骨上、多部位、胸壁、腋窝、内乳。复发后2a生存率40％、无瘤生存率24．4％，2次局部区域复发率31％，术后2a以上复发的2a生存率64％，2a以下29％。首次复发累及多部位生存率18．2％，较单一锁骨上(47．4％)及胸壁(30％)低，累及锁骨上局部复发率高于胸壁，远处转移率低于胸壁，2次局部复发胸壁最高达57％，照射野采用广泛野的局部复发率低于采用局部野。结论：对Ⅰ期、Ⅱ期乳腺癌中腋窝淋巴结阳性≥4枚或≥20％的病例应常规行术后放疗，对术后局部区域复发的病例应采用包括胸壁及锁骨上下大范围照射。     

乳腺癌改良根治术后复发高危患者的放疗结果和预后因素分析

目的 总结本院高危乳腺癌患者改良根治术后的治疗结果,探讨放疗的作用和照射野的选择,并对生存预后因素进行分析.方法 回顾性分析381例T_3～T_4期和(或)腋窝淋巴结转移数≥4个的改良根治术后乳腺癌患者临床资料.用Kaplan-Meier法计算生存率,并Logrank法检验.单因素分析临床病理和治疗因素对生存率的影响,多因素分析用Cox回归模型.结果 中位随访时间为48个月.总5年无局部区域复发率为89.7%、总生存率为76.8%.放疗显著提高5年无局部区域复发生存率(93.4%:77.1%,χ~2=19.95,P=0.000)和总生存率(80.9%:62.3%,χ~2=15.47,P=0.001).胸壁和锁骨上区域照射能提高患者的5年无胸壁复发生存率(96.8%:86.2%;χ~2=12.66,P=0.001)和无锁骨上淋巴结复发生存率(97.7%:90.7%,χ~2=9.98,P=0.002),腋窝照射对5年无腋窝复发生存率无影响(98.4%:96.1%,χ~2=0.74,P=0.389).多因素分析显示未放疗(χ~2=14.42,P=0.000)、腋窝淋巴结阳性数≥10个(χ~2=21.60,P=0.000)和T_4期(χ~2=10.79,P=0.001)是总生存率的独立不良预后因素.结论 T_3～T_4期和(或)腋窝淋巴结转移数≥4个乳腺癌患者改良根治术后放疗显著降低局部复发率和提高总生存率,照射部位可选择同侧胸壁和锁骨上淋巴结引流区.     

T1～T2期伴1～3个腋窝淋巴结转移乳腺癌患者改良根治术后放疗的作用

目的 回顾性分析370例T1～T2期、腋窝淋巴结转移数为1～3个乳腺癌患者改良根治术后的治疗结果,探讨放疗的作用.方法 用Kaplan-Meier法计算生存率,分析放疗对生存率和复发率的影响,同时分析对未放疗患者复发率有影响的临床病理因素.结果 中位随访时间为50个月(9～91个月).全组患者的5年无局部区域复发率为91.0%,总生存率为85.4%.放疗显著提高5年无局部区域复发生存率(100%和89.5%;x2=5.17,P=0.023),对总生存率无影响.对319例未行放疗患者的单因素分析显示T分期、腋窝淋巴结阳性数、C-erbB-2和PR状态是预测无复发生存率的有意义因素.结论 T1～T2期且腋窝淋巴结转移数1～3个乳腺癌患者改良根治术后,放疗显著降低局部复发率,但对总生存率无影响.T分期、腋窝淋巴结阳性数、C-erbB-2和PR状态是预测元复发生存率的有意义因素.     

33例男性乳腺癌临床分析

目的:探讨男性乳腺癌的临床特点、诊断、治疗及影响预后的因素。方法:对33例男性乳腺癌的临床资料进行回顾性分析。结果:临床分期I期3例,II期6例,III期19例,IV期5例。9例行根治术,16例行改良根治术,3例单纯乳房切除术。腋窝淋巴结转移阳性者22例,占66.7%.病理类型以浸润性非特殊型癌为主.术后放疗 化疗者14例,化疗 内分泌治疗者9例,单纯放疗和内分泌治疗者分别为5例和3例。结论:男性乳腺癌发病率低、发病年龄高、病程长、恶性程度高、预后差。治疗上应以改良根治性手术为主,辅以放、化疗、内分泌治疗的综合治疗。     

术后放疗对T1-T2期乳腺癌患者预后的影响

目的:探讨术后放疗对T1-T2期伴有1～3个腋淋巴结转移、腋窝淋巴结清除相对彻底的乳腺癌患者的疗效及其对预后的影响。方法:选择2009年8月1日-2012年1月15日上海交通大学附属第六人民医院收治的185例T1-T2期伴有1～3个腋淋巴结转移的乳腺癌患者为研究对象,分为研究组(n＝93)和对照组(n＝92)。对照组行乳腺癌改良根治术以及腋窝淋巴结清除术,研究组在此基础上行放疗。观察两组患者1、2、3年总生存率、无病生存率,并分析影响预后的独立危险因素。结果:研究组1、2、3年总生存率分别为97.83%、96.74%、89.13%,与对照组相比,差异无统计学意义(P＝0.235 6,P＝0.181 2,P＝0.128 1);研究组1、2、3年无病生存率分别为94.57%、92.39%、89.13%,显著高于对照组(P＝0.041 8,P＝0.039 0,P＝0.039 0);单因素分析表明患者术后无病生存率可能与肿瘤分期、腋窝淋巴结转移数、PR、放疗与否有关,而与患者年龄、ER、月经状态无关,进一步Cox回归分析显示腋窝淋巴结转移数(P＝0.046)、放疗与否(P＝0.012)是影响无病生存率的独立预后因素。结论:术后放疗可提高T1-T2期伴有1～3个腋淋巴结转移的乳腺癌患者无病生存率,腋窝淋巴结转移以及放疗与否是影响患者预后的独立危险因素。     

早期子宫颈癌淋巴结转移34例临床观察

目的探讨早期子宫颈癌术后淋巴结转移同步放疗、化疗与预后关系。方法回顾性分析34例早期子宫颈癌术后淋巴结转移的患者,全部行广泛性子宫切除＋盆腔淋巴结清扫术。其中Ⅰa期5例,Ⅰb期16例,Ⅱa期13例;术前放疗、化疗13例,术后全部行同步放疗、化疗;单个淋巴结转移26例,2个或2个以上淋巴结转移8例。结果淋巴结转移率22.1%（34/154）,34例淋巴结转移患者全部行术后同步放疗、化疗,5年生存率82.4%。转移淋巴结直径〈2cm者,5年生存率86.7%;转移性淋巴结直径≥2cm者,5年生存率57.9%;1个淋巴结转移至1级组患者,5年生存率76.6%;转移至2级组患者,5年生存率45.0%。结论淋巴结转移是影响子宫颈癌预后的重要因素,而术后对有淋巴结转移患者行同步放疗、化疗,可有效地提高5年生存率。     

腋窝淋巴结1～3个转移的早期乳腺癌根治术后局部复发和生存预后因素的研究

背景与目的：腋窝淋巴结1—3个阳性的早期乳腺癌进行辅助放射治疗的指征尚未明确,本研究探讨这部分患者根治术后的局部／区域复发以及生存的危险预后因素。方法：回顾性分析1998年3月至2002年3月在中山大学肿瘤防治中心接受标准或改良根治手术的217例乳腺癌病例的资料,原发肿瘤病理分期pT1期71例,pT2期146例,其中202例接受辅助化疗,51例接受辅助放疗,116例接受术后内分泌治疗。结果：中位随访时间69个月,全组的5年无局部复发生存率、无瘤生存率和总生存率分别为85．2％、81．8％和90．2％。44例出现肿瘤复发,其中21例局部／区域复发。生存分析表明,局部／区域复发患者的5年总生存率明显低于局部／区域控制的患者（61．9％vs93．6％,P〈0．0001）,患者年龄≤35岁、原发肿瘤pT2期和腋窝淋巴结转移比例≥30％是影响无局部复发生存率、无病生存率和总生存率的不良预后因素。根据这3项预后影响因素设立评分系统,发现不同分值病例的5年无局部／区域复发生存率差异具有统计学意义（P=0．0072）。在辅助化疗≥5疗程的159例患者中,接受辅助放疗的35例患者的各项生存率指标均优于未作放射治疗的患者。结论：对于腋窝淋巴结1～3个阳性的早期乳腺癌患者,年龄≤35岁、pT2期原发肿瘤和腋窝淋巴结转移比例≥30％提示术后局部／区域复发危险较高．应考虑辅助放疗。     

保乳手术治疗乳腺癌

目的　探讨保乳手术治疗临床Ⅰ、Ⅱ期乳腺癌的效果。方法　 1989年 7月至 2 0 0 3年 2月采用象限切除治疗临床单发的、肿瘤直径为 0～ 5 .0cm、无区域淋巴结转移的女性乳腺癌患者 185例 ,手术切缘距瘤缘 2 .0～ 3 .0cm ,同时行腋窝淋巴结清除术 ,术后对腋窝淋巴结阳性者 3 8例行辅助放疗、化疗 ,对 14 7例患者行全乳放疗。结果　全组随访 4～ 168个月 ,随访满 5年组总生存率 98.8% (79/80 )、无瘤生存率 96.3 % (77/80 )、局部复发率 1.3 % (1/80 )、远处转移率 3 .8% (3 /80 ) ;随访满 10年组总生存率 86.4% (19/2 2 )、无瘤生存率 81.8% (18/2 2 )、局部复发率 13 .6% (3 /2 2 )、远处转移率 18.2 % (4 /2 2 )。肿瘤直径 >2 .0cm组 ,10年局部复发率和远处转移率高于肿瘤直径≤ 2 .0cm组 (5 0 .0 %∶5 .6% ,5 0 .0 %∶11.1% ) ,但显著性差异。结论　对临床Ⅰ、Ⅱ期乳腺癌行保乳手术与改良根治术的 5年和 10年疗效相近     

密集化疗联合靶向治疗在转移性乳腺癌患者中的疗效及安全性分析

目的探讨密集化疗联合靶向治疗治疗转移性乳腺癌的疗效及安全性。方法选择68例人类表皮生长因子受体2(HER2)阳性转移性乳腺癌患者作为研究对象,根据治疗方案的不同将患者分为A组(n=30)和B组(n=38)。A组患者接受表柔比星+环磷酰胺,序贯紫杉醇的剂量密集化疗方案,B组患者在此基础上联合采用曲妥珠单抗靶向治疗。出院后,对两组患者进行为期3年的随访。比较两组患者的不良反应发生率、临床疗效、生活质量及3年总生存率。HER2阳性转移性乳腺癌患者临床疗效的影响因素采用Logistic回归分析。结果 A组患者的不良反应总发生率为40.00%,B组患者的不良反应总发生率为50.00%,差异无统计学意义(P﹥0.05)。B组患者总缓解率、生活质量核心量表(QLQ-C30)评分均明显优于A组患者(P﹤0.01)。B组和A组患者的3年生存率分别为60.0%和30.6%,B组患者的生存情况优于A组(P﹤0.05)。Logistic回归分析显示,转移器官数量是转移性乳腺癌患者临床疗效的影响因素。结论密集化疗联合靶向治疗可提高转移性乳腺癌患者的肿瘤缓解率,延长患者的生存时间,提高患者的生活质量,且安全性较好。     

2011-2014年盐城市女性乳腺癌和宫颈癌流行趋势分析

目的 全球范围内乳腺癌和宫颈癌发病率在女性恶性肿瘤中居前2位,中国过去30年女性乳腺癌死亡率呈持续上升趋势.本研究了解2011-2014年盐城市女性乳腺癌及宫颈癌的发病与死亡情况,为乳腺癌和宫颈癌的预防控制提供科学依据.方法 利用2011-2014年盐城8个肿瘤登记地区的乳腺癌和宫颈癌统计数据,分析乳腺癌和宫颈癌的发病率和死亡率及其变化.结果 2011-2014年盐城市女性乳腺癌发病率为25.37/10万,中标率为13.10/10万,世标率为16.24/10万,宫颈癌发病率为19.80/10万,中标率为10.07/10万,世标率为12.53/10万,在癌症发病构成中分别位列第4和第5位;同期乳腺癌死亡率为6.92/10万,中标率为3.24/10万,世标率为4.18/10万,宫颈癌死亡率为5.36/10万,中标率为2.39/10万,世标率为3.11/10万,在癌症死亡构成中分别位列第7和第8位.2011-2014年乳腺癌发病率呈逐年递增趋势(x2=112.21,P＜0.05),但死亡率无逐年增加的趋势(x2=1.44,P=0.23);同期宫颈癌发病率(x2=41.11,P＜0.05)和死亡率(x2=12.15,P＜0.05)均呈逐年递增趋势.结论 盐城市乳腺癌和宫颈癌严重威胁妇女健康,宫颈癌发病率和死亡率处于较高的水平,应成为女性重点预防的恶性肿瘤.     

信号传导与转录活化因子6和程序性死亡配体-1在乳腺癌组织中的表达及意义

目的 探讨信号转导与转录活化因子6(STAT6)和程序性死亡配体-1(PD-L1)在乳腺癌中的表达及意义.方法 采取2018年12月至2019年12月间玉溪市人民医院收治的手术治疗后诊断为非特殊型浸润性乳腺癌的166例患者乳腺癌组织为研究组,另选取40例癌旁组织标本为对照组,分析STAT6和PD-L1的表达,及在研究组...     

新疆喀什地区7 578例恶性肿瘤构成分析

  目的  研究新疆喀什地区维吾尔族人民恶性肿瘤的发病率和构成,为进一步进行大规模流行病学调查提供理论依据。  方法  回顾性分析2007年11月至2012年10月在喀什地区第一人民医院住院的所有恶性肿瘤患者,分别观察维族和汉族患者前十位恶性肿瘤的发病情况。  结果  共有7 578例患者入组,其中有维吾尔族患者6 840人（占90.26%）,汉族患者628人（占8.29%）,其他少数民族患者110人（占1.45%）。维吾尔族患者前10位恶性肿瘤从高到低依次为:胃癌、食管癌、白血病、子宫颈癌、恶性淋巴瘤、原发性肝癌、乳腺癌、头颈癌、肺癌和结直肠癌;汉族患者前10位恶性肿瘤从高到低依次为:肺癌、结直肠癌、乳腺癌、胃癌、原发性肝癌、头颈癌、白血病、子宫颈癌、食管癌和胰腺癌。  结论  新疆喀什地区维吾尔族人民和汉族人民的恶性肿瘤流行特点有明显的差异。      

Cancer Risk from Medical Radiation Procedures for Coronary Artery Disease: A Nationwide Population-based Cohort Study

To assess the risk of cancer incidence after medical radiation exposure for coronary artery disease (CAD),a retrospective cohort study was conducted based on Taiwan’s National Health Insurance Research Database(NHIRD). Patients with CAD were identified according to the International Classification of Diseases code, 9thRevision, Clinical Modification (ICD-9-CM), and their records of medical radiation procedures were collectedfrom 1997 to 2010. A total of 18,697 subjects with radiation exposure from cardiac imaging or therapeuticprocedures for CAD were enrolled, and 19,109 subjects receiving cardiac diagnostic procedures withoutradiation were adopted as the control group. The distributions of age and gender were similar between thetwo populations. Cancer risks were evaluated by age-adjusted incidence rate ratio (aIRR) and association withcumulative exposure were further evaluated with relative risks by Poisson regression analysis. A total of 954and 885 subjects with various types of cancers in both cohorts after following up for over 10 years were found,with incidences of 409.8 and 388.0 per 100,000 person-years, respectively. The risk of breast cancer (aIRR=1.85,95% confidence interval: 1.14-3.00) was significantly elevated in the exposed female subjects, but no significantcancer risk was found in the exposed males. In addition, cancer risks of the breast and lung were increased withthe exposure level. The study suggests that radiation exposure from cardiac imaging or therapeutic proceduresfor CAD may be associated with the increased risk of breast and lung cancers in CAD patients.     

Adjuvant radiotherapy and risk of contralateral breast cancer.

BACKGROUND: The risk of contralateral breast cancer is increased twofold to fivefold for breast cancer patients. A registry-based cohort study in Denmark suggested that radiation treatment of the first breast cancer might increase the risk for contralateral breast cancer among 10-year survivors. PURPOSE: Our goal was to assess the role of radiation in the development of contralateral breast cancer. METHODS: A nested case-control study was conducted in a cohort of 56,540 women in Denmark diagnosed with invasive breast cancer from 1943 through 1978. Case patients were 529 women who developed contralateral breast cancer 8 or more years after first diagnosis. Controls were women with breast cancer who did not develop contralateral breast cancer. One control was matched to each case patient on the basis of age, calendar year of initial breast cancer diagnosis, and survival time. Radiation dose to the contralateral breast was estimated for each patient on the basis of radiation measurements and abstracted treatment information. The anatomical position of each breast cancer was also abstracted from medical records. RESULTS: Radiotherapy had been administered to 82.4% of case patients and controls, and the mean radiation dose to the contralateral breast was estimated to be 2.51 Gy. Radiotherapy did not increase the overall risk of contralateral breast cancer (relative risk = 1.04; 95% confidence interval = 0.74-1.46), and there was no evidence that risk varied with radiation dose, time since exposure, or age at exposure. The second tumors in case patients were evenly distributed in the medial, lateral, and central portions of the breast, a finding that argues against a causal role of radiotherapy in tumorigenesis. CONCLUSIONS: The majority of women in our series were perimenopausal or postmenopausal (53% total versus 38% premenopausal and 9% of unknown status) and received radiotherapy at an age when the breast tissue appears least susceptible to the carcinogenic effects of radiation. Based on a dose of 2.51 Gy and estimates of radiation risk from other studies, a relative risk of only 1.18 would have been expected for a population of women exposed at an average age of 51 years. Thus, our data provide additional evidence that there is little if any risk of radiation-induced breast cancer associated with exposure of breast tissue to low-dose radiation (e.g., from mammographic x rays or adjuvant radiotherapy) in later life.     

Preliminary results of quadrantectomy and radiation therapy for breast cancer

Between November 1987 and December 1992, a total of 200 breast carcinomas in 199 patients were treated by definitive radiation therapy following quadrantectomy and level III axillary dissection. One patient with simultaneous bilateral breast cancers was excluded and 198 patients with breast cancer were enrolled in this study. There were 9 Stage 0, 117 Stage I and 72 Stage II tumors by the UICC tumor classification system (1987). Histological examination revealed that 9 tumors were non-invasive carcinomas and 189 were invasive carcinomas. For radiation therapy, a total of 50 Gy was delivered to the ipsilateral breast using⁶⁰Co γ rays. In three cases with level III lymph node involvement, the ipsilateral supraclavicular and parasternal regions were also irradiated. Boost irradiation was given to 8 of 12 margin-positive patients, and 2 of 24 patients in whom tumor cells were present within 5 mm from the margin. We used a CT simulator for the treatment planning of radiation therapy in 196 tumors. During follow-up for 16-77 months (median: 35 months), 2 patients died of unrelated causes and 6 developed distant metastasis (4 to bone and 2 to lung). Local recurrence was noted in 1 patient. Acute reactions to radiation therapy included moist desquamation involving the tip of the breast and the axilla in 14 and 5 patients, respectively, as well as bright erythema in 7 patients. Late reactions included arm edema in 12 patients, patchy depigmentation at the tip of the breast in 5 patients, moderate telangiectasia in 1 patient, and symptomatic radiation pneumonitis in 1 patient. The actuarial overall survival, cause-specific survival, disease-free survival, and relapse-free survival rates at 5 years were97.2%, 100%, 93.5%, and 93.0%, respectively. This excellent locoregional control, together with a highly acceptable toxicity strongly suggests the usefulness of quadrantectomy and radiation therapy for Japanese women with breast cancer. The possible indications include clinical Stage 0 and, I breast cancer, and clinical Stage II cancer in patients with relatively large breasts and with the primary tumor not located close to the nipple.     

腹腔镜胃癌根治术对患者的疗效及对CEA、CA199的影响

目的研究腹腔镜胃癌根治术(LRG)对患者的疗效及对癌胚抗原(CEA)、血清糖类抗原199(CA199)的影响。方法选择行手术治疗的胃癌患者185例,根据手术方案的不同将患者分成观察组(LRG术式)95例及对照组(传统的开腹术式)90例,对比两组手术疗效指标,不同时期的白细胞介素-2(IL-2)及白细胞介素-6(IL-6)炎症因子水平,CEA及CA199水平,以及术后并发症的发生情况。结果观察组除淋巴结清扫数目较对照组无明显差异外,其切口长度和手术时间,及术中出血量和排气时间,以及住院时间均分别明显优于对照组,差异均有统计学意义(P<0.05)。术后5d两组的IL-2及IL-6水平明显高于术前,但观察组的IL-2及IL-6水平仍明显低于对照组,差异均有统计学意义(P<0.05)。两组术后5 d的CEA及CA199水平相比差异不显著(P>0.05),但均明显低于术前,差异有统计学意义(P<0.05)。观察组术后并发症的总发生率为2.11%,明显低于对照组的8.89%,差异有统计学意义(P<0.05)。结论应用LRG术式治疗胃癌患者可获得较好的疗效,同时还可有效降低CEA及CA199的水平,安全性较高,值得推广。     

Local-regional control in breast cancer patients with a possible genetic predisposition

PURPOSE: Local control rates for breast cancer in genetically predisposed women are poorly defined. Because such a small percentage of breast cancer patients have proven germline mutations, surrogates, such as a family history for breast cancer, have been used to examine this issue. The purpose of this study was to evaluate local-regional control following breast conservation therapy (BCT) in patients with bilateral breast cancer and a breast cancer family history. METHODS AND MATERIALS: We retrospectively reviewed records of all 58 patients with bilateral breast cancer and a breast cancer family history treated in our institution between 1959 and 1998. The primary surgical treatment was a breast-conserving procedure in 55 of the 116 breast cancer cases and a mastectomy in 61. The median follow-up was 68 months for the BCT patients and 57 months for the mastectomy-treated patients. RESULTS: Eight local-regional recurrences occurred in the 55 cases treated with BCT, resulting in 5- and 10-year actuarial local-regional control rates of 86% and 76%, respectively. In the nine cases that did not receive radiation as a component of their BCT, four developed local-regional recurrences (5- and 10-year local-regional control rates of BCT without radiation: 49% and 49%). The 5- and 10-year actuarial local-regional control rates for the 46 cases treated with BCT and radiation were 94% and 83%, respectively. In these cases, there were two late local recurrences, developing at 8 years and 9 years, respectively. A log rank comparison of radiation versus no radiation actuarial data was significant at p = 0.009. In the cases treated with BCT, a multivariate analysis of radiation use, patient age, degree of family history, margin status, and stage revealed that only the use of radiation was associated with improved local control (Cox regression analysis p = 0.021). The 10-year actuarial rates of local-regional control following mastectomy with and without radiation were 91% and 89%, respectively. CONCLUSIONS: Patients with a possible genetic predisposition to breast cancer had low 5-year rates of local recurrence when treated with breast conserving surgery and radiation, but the local failure rate exceeded 50% when radiation was omitted. Our data are consistent with the hypothesis that patients with an underlying genetic predisposition develop cancers with radiosensitive phenotypes.