Results of treatment of primary breast carcinoma by radical radiotherapy with artificial pneumothorax

One hundred and forty-three women with primary breast carcinoma were treated by radical radiotherapy associated with artificial pneumothorax to include the breast and lymphatics en bloc with large opposed fields. Surgery was restricted to local excision or drill biopsy. Most patients received a tumour dose of 5200–5600 cGy in 19–22 fractions over 4 weeks and were followed up for at least 5 years. Local control was achieved in 87% of T 1, 52% of T 2, 27% of T 3 and 23% of T 4 tumours. For T 2 tumours local control was greater following excision biopsy (75%) than when surgery was more limited (21%). Acute morbidity was mostly minor and self-limiting. The commonest permanent late complication was restriction of shoulder movement in 20 patients. This method although safe and feasible does not offer significant advantages over conventional techniques.