title: Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?
abstract: OBJECTIVE
  To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications.
  
  
  METHODS
  A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging.
  
  
  RESULTS
  Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology-Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. "No change" was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type).
  
  
  CONCLUSIONS
  No statistically significant changes in follow-up mammographies 5-9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection.
  
  
  CONCLUSIONS
  The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after AWB-RT treatment (up to 5-9 years after radiotherapy) justifies large-scale use of AWB-RT treatment without hindrance in tumour recurrence diagnosis.
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bagnera
authors.affiliation: 2 Breast Screening Unit (Regional Reference Center), Regional Hospital A.O.U. City of Health and Science of Turin, Turin, Italy.
authors.forename: Luisella
authors.initials: L
authors.lastname: Milanesio
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Piero B
authors.initials: PB
authors.lastname: Brachet Cota
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Berrino
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Cataldi
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gatti
authors.affiliation: 3 Department of Surgery , Ivrea Community Hospital (A.S.L. TO4), Turin, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Mondini
authors.affiliation: 3 Department of Surgery , Ivrea Community Hospital (A.S.L. TO4), Turin, Italy.
authors.forename: Ovidio
authors.initials: O
authors.lastname: Paino
authors.affiliation: 4 Department of Pathology, Ivrea Community Hospital (A.S.L. TO4), Turin, Italy.
authors.forename: Erika G
authors.initials: EG
authors.lastname: Comello
authors.affiliation: 4 Department of Pathology, Ivrea Community Hospital (A.S.L. TO4), Turin, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Orlassino
authors.affiliation: 5 Department of Medical Physics, A.O. Ordine Mauriziano di Torino, Turin, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Pasquino
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Cante
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Maria R
authors.initials: MR
authors.lastname: La Porta
authors.affiliation: 1 Department of Diagnostic Imaging and RT-A.S.L. TO4 (Ciriè Community Hospital, Ivrea Community Hospital, Chivasso Community Hospital), Turin, Italy.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Patania
authors.affiliation: 6 Local Health Authority Turin 4 (A.S.L. TO4), Turin, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Valle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000071060:Breast Density; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy* / Q000601:surgery; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D042361:Mammary Glands, Human / Q000002:abnormalities*; D008875:Middle Aged; D011859:Radiography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies