Patient-reported Long-term Cosmetic Outcomes Following Short Fractionation Whole Breast Radiotherapy With Boost.
To evaluate the cosmetic effect of a tumor-bed boost after hypofractionated whole breast irradiation (HF-WBI+B) using a patient-reported questionnaire.



Between 2000 and 2005, 4392 women aged 75 years and younger with unilateral early-stage breast cancer received HF-WBI alone or HF-WBI+B. From each group, 800 randomly sampled surviving and nonrelapsed women were invited to complete the Breast Cancer Treatment Outcomes Scale questionnaire.



A total of 312 women completed the questionnaire: 154 received HF-WBI alone and 158 received HF-WBI+B. Median ages of respondents were 57 years for HF-WBI alone and 52 years for HF-WBI+B (P<0.001). Women receiving HF-WBI+B had a shorter follow-up interval, higher T stage, higher grade, and were more likely to have had nodal radiotherapy and chemotherapy. There were similar responses comparing the overall appearance of the treated to untreated breast (42% stating no or slight difference for HF-WBI alone vs. 41% for HF-WBI+B, P=0.87). The HF-WBI+B group was: (a) slightly worse on the cosmetic subscale (2.3 vs. 2.1, P=0.02); (b) worse on the pain subscale (2.0 vs. 1.6, P<0.0001); but (c) better on the functional subscale (1.5 vs. 1.8, P<0.001). When the pain subscale was applied to the area around the scar (a surrogate for the tumor-bed), the 2 groups were similar (2.0 vs. 2.0, P=0.71).



Similar to conventional fractionated whole breast radiotherapy with a tumor-bed boost, women who received short fractionation whole breast radiotherapy with boost self-report only slightly worse long-term cosmetic and pain outcomes compared with women who received short fractionation alone.
*Department of Oncology, Saint John Regional Hospital, Saint John, NB †Faculty of Medicine, University of British Columbia ‡Department of Radiation Oncology §Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Centre, Vancouver, BC, Canada.
Elisa K
EK
Chan
Nazlee
N
Tabarsi
Scott
S
Tyldesley
Mohamed
M
Khan
Ryan
R
Woods
Caroline
C
Speers
Lorna
L
Weir
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000532:radiotherapy* / Q000601:surgery; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D010146:Pain / Q000209:etiology; D000071066:Patient Reported Outcome Measures; D000069473:Radiation Dose Hypofractionation; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D011795:Surveys and Questionnaires; D013997:Time Factors