Kari M Rosenkranz1, Karla Ballman2, Linda McCall3, Colleen McCarthy4, Charlotte D Kubicky5, Laurie Cuttino6, Kelly K Hunt7, Armando Giuliano8, Kimberly J Van Zee4, Bruce Haffty9, Judy C Boughey10. 1. Dartmouth Hitchcock Medical Center, Lebanon, NH, USA. kari.m.rosenkranz@hitchcock.org. 2. Alliance Statistics and Data Center, Weill Medical College of Cornell University, New York, NY, USA. 3. Alliance Statistics and Data Center, Duke University, Durham, NC, USA. 4. Memorial Sloan Kettering Cancer Center, New York, NY, USA. 5. Sutter Cancer Center, Sacramento, CA, USA. 6. Virginia Commonwealth University Health System, Richmond, VA, USA. 7. The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 8. Cedars-Sinai Medical Center, Los Angeles, CA, USA. 9. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 10. Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Diagnoses of multiple ipsilateral breast cancer (MIBC) are increasing. Historically, the primary treatment for MIBC has been mastectomy due to concerns about in-breast recurrence risk and poor cosmetic outcome. The Alliance Z11102 study prospectively assessed cosmetic outcomes in women with MIBC treated with breast-conserving therapy (BCT). PATIENTS AND METHODS: Z11102 was a multicenter trial enrolling women with two or three separate sites of biopsy-proven malignancy separated by ≥ 2 cm within the same breast. Cosmetic outcome was a planned secondary endpoint. Data were collected with a four-point cosmesis survey (1 = excellent, 4 = poor) and the BREAST-Q (scored 0-100). All patients undergoing successful breast-conserving therapy were treated with whole-breast radiation. Associations were assessed with Chi square or Fisher's exact tests as appropriate. RESULTS: Cosmetic outcome data for 216 eligible women who completed therapy are included in this analysis. Of the 136 patients who completed the survey 2 years postoperatively, 70.6% (N = 96) felt the result was good or excellent, while 3.7% (N = 5) felt the result was poor. We found no significant differences in patient-reported cosmetic outcomes when stratifying by patient age, number of lesions (two or three), number of incisions, number of lumpectomies, or size of largest area of disease. Mean satisfaction score on the BREAST-Q was 77.2 at 6 months following whole-breast radiation and 73.7 at 3 years following surgery. CONCLUSIONS: BCT performed for MIBC results in good or excellent cosmesis for the majority of women. From a cosmetic perspective, BCT is a valid surgical approach to women with MIBC. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01556243.
BACKGROUND: Diagnoses of multiple ipsilateral breast cancer (MIBC) are increasing. Historically, the primary treatment for MIBC has been mastectomy due to concerns about in-breast recurrence risk and poor cosmetic outcome. The Alliance Z11102 study prospectively assessed cosmetic outcomes in women with MIBC treated with breast-conserving therapy (BCT). PATIENTS AND METHODS: Z11102 was a multicenter trial enrolling women with two or three separate sites of biopsy-proven malignancy separated by ≥ 2 cm within the same breast. Cosmetic outcome was a planned secondary endpoint. Data were collected with a four-point cosmesis survey (1 = excellent, 4 = poor) and the BREAST-Q (scored 0-100). All patients undergoing successful breast-conserving therapy were treated with whole-breast radiation. Associations were assessed with Chi square or Fisher's exact tests as appropriate. RESULTS: Cosmetic outcome data for 216 eligible women who completed therapy are included in this analysis. Of the 136 patients who completed the survey 2 years postoperatively, 70.6% (N = 96) felt the result was good or excellent, while 3.7% (N = 5) felt the result was poor. We found no significant differences in patient-reported cosmetic outcomes when stratifying by patient age, number of lesions (two or three), number of incisions, number of lumpectomies, or size of largest area of disease. Mean satisfaction score on the BREAST-Q was 77.2 at 6 months following whole-breast radiation and 73.7 at 3 years following surgery. CONCLUSIONS: BCT performed for MIBC results in good or excellent cosmesis for the majority of women. From a cosmetic perspective, BCT is a valid surgical approach to women with MIBC. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01556243.
Authors: A S Lichter; M E Lippman; D N Danforth; T d'Angelo; S M Steinberg; E deMoss; H D MacDonald; C M Reichert; M Merino; S M Swain Journal: J Clin Oncol Date: 1992-06 Impact factor: 44.544
Authors: W F Hartsell; D C Recine; K L Griem; M A Cobleigh; T R Witt; A K Murthy Journal: Int J Radiat Oncol Biol Phys Date: 1994-08-30 Impact factor: 7.038
Authors: Natalie D Chand; Victoria Browne; Nirmala Paramanathan; Lashan J Peiris; Siobhan A Laws; Richard M Rainsbury Journal: Plast Reconstr Surg Glob Open Date: 2017-07-24
Authors: Kate R Pawloski; Nicole Christian; Andrea Knezevic; Hannah Y Wen; Kimberly J Van Zee; Monica Morrow; Audree B Tadros Journal: Breast Cancer Res Treat Date: 2020-08-28 Impact factor: 4.872
Authors: Fernando A Angarita; Robert Brumer; Matthew Castelo; Nestor F Esnaola; Stephen B Edge; Kazuaki Takabe Journal: Cancers (Basel) Date: 2022-09-20 Impact factor: 6.575