A comparison in cosmetic outcome between per-operative interstitial breast implants and delayed interstitial breast implants after external beam radiotherapy.
OBJECTIVE
Interstitial implants for brachytherapy boost in the breast conserving therapy of breast cancer can be performed in two ways; implants during the tumor excision (per-operative implants) or after the external beam therapy (delayed interstitial implants). Differences in cosmetic outcome were investigated.


METHODS
Cosmetic results in 47 patients having a per-operative implant were compared to 123 patients having a delayed interstitial implant in a matched case-control study. Cosmesis was scored on a four-point-scale varying from 0 (excellent) to 3 (poor).


RESULTS
After mean follow-up of 63 months, three observers found no difference in cosmetic outcome between the two groups after adjustment for variables found to be related with cosmesis (difference in mean score 0.50, P=0.26). Implant volume at 100% isodose was not found to differ (P=0.084) between the per-operative group (mean 102 cm3, S.D. 34 cm3) and the delayed group (mean 93 cm3, S.D. 29 cm3).


CONCLUSIONS
Performing per-operative implants has not led to smaller implants. The method of performing brachytherapy does not result in marked differences in cosmetic outcome.
Pieters
Bradley R
BR
The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Hart
Augustinus A M
AA
Russell
Nicola S
NS
Jansen
Edwin P M
EP
Peterse
Johannes L
JL
Borger
Jacques
J
Rutgers
Emiel J Th
EJ
D001918:Brachytherapy / Q000009:adverse effects; D001940:Breast / Q000528:radiation effects* / Q000601:surgery; D019928:Breast Implantation / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D007430:Intraoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome