Symptoms 10-17 years after breast cancer radiotherapy data from the randomised SWEBCG91-RT trial.
BACKGROUND
Postoperative radiotherapy decreases the risk for local recurrence and improves overall survival in women with breast cancer. We have limited information on radiotherapy-induced symptoms 10-17 years after therapy.


METHODS
Between 1991 and 1997, women with lymph node-negative breast cancer were randomised in a Swedish multi-institutional trial to breast conserving surgery with or without postoperative radiotherapy. In 2007, 10-17 years after randomisation, the group included 422 recurrence-free women. We collected data with a study-specific questionnaire on eight pre-selected symptom groups.


RESULTS
For six symptom groups (oedema in breast or arm, erysipelas, heart symptoms, lung symptoms, rib fractures, and decreased shoulder mobility) we found similar occurrence in both groups. Excess occurrence after radiotherapy was observed for pain in the breast or in the skin, reported to occur "occasionally" by 38.1% of survivors having undergone radiotherapy and surgery versus 24.0% of those with surgery alone (absolute difference 14.1%; p=0.004) and at least once a week by 10.3% of the radiotherapy group versus 1.7% (absolute difference 8.6%; p=0.001). Daily life and analgesic use did not differ between the groups.


CONCLUSIONS
Ten to 17 years after postoperative radiotherapy 1 in 12 women had weekly pain that could be attributed to radiotherapy. The symptoms did not significantly affect daily life and thus the reduced risk for local recurrence seems to outweigh the risk for long-term symptoms for most women.
Lundstedt
Dan
D
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden. dan.lundstedt@vgregion.se
Gustafsson
Magnus
M
Malmström
Per
P
Johansson
Karl-Axel
KA
Alsadius
David
D
Sundberg
Agnetha
A
Wilderäng
Ulrica
U
Holmberg
Erik
E
Anderson
Harald
H
Steineck
Gunnar
G
Karlsson
Per
P
D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010146:Pain / Q000150:complications*; D011832:Radiation Injuries / Q000150:complications; D011878:Radiotherapy / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors