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Radiotherapy alone or in combination with surgery in the management of stage III breast cancer.

239 women with stage III carcinoma of the breast were treated by primary radiation therapy from 1977 to 1985. Of them 212 had an objective response and 27 showed no response to irradiation. From the objective responders, 105 patients were subjected to mastectomy and axillary dissection and in 107 cases the radiotherapy was not followed by surgery. Patients of operated group had a 71% and the RT alone group had a 61% local-regional tumor control at 5 years. The analysis of local-regional recurrences revealed that none of the operated patients had axillary recurrence but 8 had in the RT alone group. Postirradiation surgery is recommended for patients who have residual disease especially in the axillary region. The 5-year survival rate of operated patients was significantly better, 58% vs. 35%. However, these results are not comparable since the incidence of less favourable cases was higher in the RT alone group. Chemotherapy was initiated for the 27 patients who failed to respond to RT, but results were unsatisfactory. None of them survived three years. Further studies are needed to explore the role of chemotherapy in this stage of breast cancer.