title: Cosmesis and Breast-Related Quality of Life Outcomes After Intraoperative Radiation Therapy for Early Breast Cancer: A Substudy of the TARGIT-A Trial.
abstract: To report the first comprehensive investigation of patient-reported cosmesis and breast-related quality of life (QOL) outcomes comparing patients randomized to risk-adapted single-dose intraoperative radiation therapy (TARGIT-IORT) versus external beam radiation therapy (EBRT) on the TARGIT-A trial.
  
  
  
  Longitudinal cosmesis and QOL data were collected from a subset of TARGIT-A participants who received TARGIT-IORT as a separate procedure (postpathology). Patients completed a cosmetic assessment before radiation therapy and annually thereafter for at least 5 years. Patients also completed the combined European Organization for Research and Treatment of Cancer (EORTC) core questionnaire and Breast-Specific Module in addition to the Body Image after Breast Cancer Questionnaire at baseline and annually thereafter. The combined EORTC questionnaires were also collected 3, 6, and 9 months after wide local excision.
  
  
  
  An Excellent-Good cosmetic result was scored more often than a Fair-Poor result for both treatment groups across all time points. The TARGIT-IORT patients reported better breast-related QOL than EBRT patients. Statistically and clinically significant differences were seen at month 6 and year 1, with EBRT patients having moderately worse breast symptoms (a statistically significant difference of more than 10 in a 100-point scale) than TARGIT-IORT patients at these time points.
  
  
  
  Patients treated with TARGIT-IORT on the TARGIT-A trial have similar self-reported cosmetic outcome but better breast-related QOL outcomes than patients treated with EBRT. This important evidence can facilitate the treatment decision-making process for patients who have early breast cancer suitable for breast-conserving surgery and inform their clinicians.
authors: Radiation Oncology Clinical Trials and Research Unit, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia. Electronic address: Tammy.Corica@health.wa.gov.au.
authors: Tammy
authors: T
authors: Corica
authors: School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia; Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
authors: Anna K
authors: AK
authors: Nowak
authors: School of Surgery, University of Western Australia, Crawley, Western Australia, Australia; Department of Surgery Fiona Stanley Hospital, Western Australia, Australia.
authors: Christobel M
authors: CM
authors: Saunders
authors: Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia.
authors: Max
authors: M
authors: Bulsara
authors: Radiation Oncology, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital Nedlands, Western Australia, Australia.
authors: Mandy
authors: M
authors: Taylor
authors: Department of Surgery, Royal Free Hospital, London, United Kingdom; Clinical Trials Group, Division of Surgery and Interventional Science, University College, London, London, United Kingdom; Department of Surgery, Whittington Health, London, UK.
authors: Jayant S
authors: JS
authors: Vaidya
authors: Clinical Trials Group, Division of Surgery and Interventional Science, University College London, London, United Kingdom.
authors: Michael
authors: M
authors: Baum
authors: School of Surgery, University of Western Australia, Western Australia, Australia; Genesis Cancer Care, Western Australia, Australia; Radiation Oncology, Comprehensive Cancer Centre, Sir Charles Gairdner Hospital, Western Australia, Australia.
authors: David J
authors: DJ
authors: Joseph
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D038622:Internationality; D007430:Intraoperative Care / Q000379:methods; D008137:Longitudinal Studies; D008408:Mastectomy / Q000401:mortality* / Q000706:statistics & numerical data; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000401:mortality / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*; D020266:Radiotherapy, Conformal / Q000401:mortality* / Q000706:statistics & numerical data; D012307:Risk Factors; D055502:Secondary Prevention; D015996:Survival Rate; D016896:Treatment Outcome