الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Before the era of adjuvant systemic therapies extensive local & regional treatment often including radiotherapy, was used frequently in the treatment of breast cancer. The addition of radiotherapy to surgery reduced the number of local & regional recurrences. During the last 50 years , the efficacy of postoperative locoregional radiation to chest wall & regional LN in women who have undergone surgery for breast cancer has been examined in a number of randomized clinical trials. Many of these studies showed controversial results .Hence , the role of postoperative locoregional radiation was unclear & as a result there is a variation in its use in clinical practice . Because radiotherapy is a resource consuming & may be followed by severe late effects, it should be reserved for patients who are at high risk.
The lifetime risk for developing breast cancer has been reported to be as high as 12%, whereas the risk of death has been reported to be as high as 5%. Breast cancer constitute 30% of all new malignant neoplasms and 16% of deaths from cancer in women. In Egypt, breast cancer is the most prevalent female malignancy. In Alexandria, it accounts for about 48% of all malignancies in females.
The exact cause of breast cancer is unknown; however, there are a number of genetic and acquired risk factors that have been associated with a higher incidence of breast cancer such as age, race, early menarche, late menopause, nulliparity, late onset of first full term pregnancy, the use of oral contraceptive pills, hormonal replacement therapy in post menopausal women, previous radiation exposure, positive family history, genetic mutations such as BRCA1 and BRCA2 genes, obesity, dietary factors and some benign breast diseases such as lobular carcinoma insitu and atypical hyperplasia.
This work aimed to study the role of postoperative regional irradiation in breast cancer patients following mastectomy with node negative & or 1-3 positive nodes. In terms of local & regional recurrence rate. As well as disease free survival (DFS) & over-all survival rate (OS).
In this study we retrospectively reviewed the files of 663 female breast cancer patients with pathologically proven either node negative or 1-3 positive nodes treated at the Department of Cancer Management & Research, Medical Research Institute, Alexandria University between January 2000 and December 2009, who we had full data about locoregional recurrence , disease free survival & overall survival .
Data collected from patients files included:
1- Clinicopathological data:
A- Patients clinical features:
E) Age at time of presentation.
F) Menstrual status (at time of presentation ).G) Parity.H)Family history of breast cancer.B -Pathological feature that have been evaluated i -Total number of dissected axillary lymph nodes.
ii-Tumor size (in cm.).
iii-Number of involved nodes.
iv-ER /PR status.
v-Her-2 status if present.
vi-Lymphovascular invasion.