title: Quality of life and cosmesis after breast cancer: whole breast radiotherapy vs partial breast high-dose-rate brachytherapy.
abstract: OBJECTIVE
  Conservative surgery and radiotherapy for early breast cancer offers a better quality of life than mastectomy. As 80-85% of breast relapses develop close to the tumour bed, partial breast irradiation was developed to overcome drawbacks with standard radiotherapy. This study compares quality of life and cosmesis after partial breast multi-catheter high-dose rate interstitial brachytherapy or standard radiotherapy.
  
  
  METHODS
  A questionnaire, exploring body image, fear of recurrence, satisfaction with treatment and cosmesis, was administered to 39 partial and 78 whole breast patients at a median of 20 and 80 months after radiotherapy. Patients' and physicians' cosmetic assessments were compared.
  
  
  RESULTS
  Groups were well-matched, except for: a higher percentage of chemotherapy-treated patients in the whole breast group and a older median age and a higher percentage of infiltrating ductal carcinoma G1 in partial breast group. At first and second analysis no significant inter-group difference emerged on body image and fear of recurrence, while partial breast patients were more satisfied with cosmetic outcome and at first analysis with treatment. Comparing results from first and second analysis into each treatment group, body image was significantly better at the first analysis in both groups. Fear of recurrence was unchanged. No differences were found in cosmesis as assessed by patients. At first and second analyses physicians' assessment of cosmesis was significantly better in the partial breast group.
  
  
  CONCLUSIONS
  Even at longer follow-up, quality of life is similar after partial or whole breast irradiation. Cosmesis is better after partial breast irradiation.
authors.affiliation: Radiation Oncology Section, Santa Maria della Misericordia Hospital, Perugia - Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Perrucci
authors.forename: Valentina
authors.initials: V
authors.lastname: Lancellotta
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Falcinelli
authors.forename: Alessia
authors.initials: A
authors.lastname: Farneti
authors.forename: Manuela
authors.initials: M
authors.lastname: Margaritelli
authors.forename: Giorgia
authors.initials: G
authors.lastname: Capezzali
authors.forename: Isabella
authors.initials: I
authors.lastname: Palumbo
authors.forename: Cynthia
authors.initials: C
authors.lastname: Aristei
mesh_terms: D000328:Adult; D000368:Aged; D001828:Body Image; D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery; D005239:Fear; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome