BACKGROUND AND PURPOSE: Large breast size is associated with an increased risk of late adverse effects after breast conservation surgery and radiotherapy, even when 3D dosimetry is used. The purpose of this study is to test the hypothesis that residual dose inhomogeneity is sufficient to explain the association. METHODS: Patients previously treated after breast conservation surgery with whole breast radiotherapy using 3D dosimetry and followed up in the UK FAST hypofractionation trial were selected for this analysis. The residual level of dose inhomogeneity across the whole breast treatment volume was used to test for association between residual dosimetry and post-treatment change in breast appearance at 2 years post-radiotherapy. RESULTS: At 2 years, 201/279 (72%) of women had no change in photographic breast appearance, 61 (22%) had mild change and 17 (6%) had marked change. Breast size and dosimetry were both significantly associated with late effects in univariate analyses, but only breast size remained an independent significant risk factor for change in breast appearance when included in a multiple regression model together with other prognostic factors (p=0.006 for trend). CONCLUSION: Large-breasted women are more likely to suffer change in breast size and shape after whole breast radiotherapy delivered using 3D dosimetry, but residual dose inhomogeneity is insufficient to explain the association.
RCT Entities:
BACKGROUND AND PURPOSE: Large breast size is associated with an increased risk of late adverse effects after breast conservation surgery and radiotherapy, even when 3D dosimetry is used. The purpose of this study is to test the hypothesis that residual dose inhomogeneity is sufficient to explain the association. METHODS:Patients previously treated after breast conservation surgery with whole breast radiotherapy using 3D dosimetry and followed up in the UK FAST hypofractionation trial were selected for this analysis. The residual level of dose inhomogeneity across the whole breast treatment volume was used to test for association between residual dosimetry and post-treatment change in breast appearance at 2 years post-radiotherapy. RESULTS: At 2 years, 201/279 (72%) of women had no change in photographic breast appearance, 61 (22%) had mild change and 17 (6%) had marked change. Breast size and dosimetry were both significantly associated with late effects in univariate analyses, but only breast size remained an independent significant risk factor for change in breast appearance when included in a multiple regression model together with other prognostic factors (p=0.006 for trend). CONCLUSION: Large-breasted women are more likely to suffer change in breast size and shape after whole breast radiotherapy delivered using 3D dosimetry, but residual dose inhomogeneity is insufficient to explain the association.
Authors: F Sedlmayer; M L Sautter-Bihl; W Budach; J Dunst; P Feyer; R Fietkau; W Haase; W Harms; C Rödel; R Souchon; F Wenz; R Sauer Journal: Strahlenther Onkol Date: 2013-03 Impact factor: 3.621
Authors: Simona F Shaitelman; Xiudong Lei; Alastair Thompson; Pamela Schlembach; Elizabeth S Bloom; Isidora Y Arzu; Daniel Buchholz; Gregory Chronowski; Tomas Dvorak; Emily Grade; Karen Hoffman; George Perkins; Valerie K Reed; Shalin J Shah; Michael C Stauder; Eric A Strom; Welela Tereffe; Wendy A Woodward; Diana N Amaya; Yu Shen; Gabriel N Hortobagyi; Kelly K Hunt; Thomas A Buchholz; Benjamin D Smith Journal: J Clin Oncol Date: 2018-10-31 Impact factor: 44.544
Authors: Eunkyung Lee; Cristiane Takita; Jean L Wright; Isildinha M Reis; Wei Zhao; Omar L Nelson; Jennifer J Hu Journal: Pain Date: 2016-05 Impact factor: 7.926