Morbidity of surgical treatment for advanced cancer of the breast after irradiation

The authors reviewed the medical files of 100 patients with locally advanced breast cancer (stage III), treated in the department of surgery of the Institut Jules-Bordet between 1974 and 1988. All patients received preoperative radiotherapy (average total dose of 45 Grays). This preoperative irradiation was associated with chemotherapy in 74% of patients. All patients subsequently underwent surgery and a modified radical mastectomy was performed in 92% of cases. Our data analysis reveals an incidence of 25% of local wound infections, 34% of delayed wound healing, 63% of seroma formation and 22% of lymphoedema of the upper limb. The local postoperative morbidity appears to be increased in patients preoperatively irradiated. This indicates that preoperative chemotherapy may be preferable in these patients to minimise the local postoperative morbidity and its impact on the quality of life.