title: The influence of breast size on late radiation effects and association with radiotherapy dose inhomogeneity.
abstract: A prospective assessment of late changes in breast appearance in 559 patients after tumour excision and radiotherapy for early breast cancer noted a strong association with breast size. Only 3/48 (6%) patients with small breasts developed moderate or severe late changes compared with 94/423 (22%) with medium sized breasts and 34/88 (39%) patients with large breasts (p < 0.001). One possibility is that greater radiation changes are related to greater dose inhomogeneity in women with large breasts. To explore this hypothesis, radiation dose distributions were assessed in a separate group of 37 women in whom three-level transverse computer tomographic images of the breast in the treatment position were available. A significant correlation was found between breast size and dose inhomogeneity which may account for the marked changes in breast appearance reported in women with large breasts.
authors.affiliation: Department of Radiotherapy and Oncology, Royal Marsden Hospital, Sutton, Surrey, UK.
authors.forename: A M
authors.initials: AM
authors.lastname: Moody
authors.forename: W P
authors.initials: WP
authors.lastname: Mayles
authors.forename: J M
authors.initials: JM
authors.lastname: Bliss
authors.forename: R P
authors.initials: RP
authors.lastname: A'Hern
authors.forename: J R
authors.initials: JR
authors.lastname: Owen
authors.forename: J
authors.initials: J
authors.lastname: Regan
authors.forename: B
authors.initials: B
authors.lastname: Broad
authors.forename: J R
authors.initials: JR
authors.lastname: Yarnold
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000033:anatomy & histology / Q000528:radiation effects; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D013997:Time Factors; D014057:Tomography, X-Ray Computed