TY - JOUR
T1 - Long-term cosmetic outcome after preoperative radio-/chemotherapy in locally advanced breast cancer patients
AU - Matuschek, Christiane
AU - Nestle-Kraemling, Carolin
AU - Haussmann, Jan
AU - Bölke, Edwin
AU - Wollandt, Sylvia
AU - Speer, Vanessa
AU - Djiepmo Njanang, Freddy Joel
AU - Tamaskovics, Bálint
AU - Gerber, Peter Arne
AU - Orth, Klaus
AU - Ruckhaeberle, Eugen
AU - Fehm, Tanja
AU - Corradini, Stefanie
AU - Lammering, Guido
AU - Mohrmann, Svjetlana
AU - Audretsch, Werner
AU - Roth, Stephan
AU - Kammers, Kai
AU - Budach, Wilfried
N1 - Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: Preoperative radiotherapy and chemoradiotherapy (PRT/PCRT) represent an increasingly used clinical strategy in different tumor sites. We have previously reported on a PRT/PRCT protocol in patients with locally advanced non-inflammatory breast cancer (LABC) with promising clinical results. However, concerns regarding a possible unfavorable influence on cosmesis still exist. Thus, the aim of the current study was to examine long-term cosmetic outcome in our series of LABC patients treated with PRT/PCRT followed by breast-conserving surgery (BCS) or mastectomy (ME). Patients and methods: Of the 315 patients treated with PRT/PCRT in the years 1991 to 1999, 203 were still alive at long-term follow-up of mean 17.7 years (range 14–21). Thirty-seven patients were lost to follow-up and 58 patients refused to be contacted, which resulted in 107 patients (64 patients after BCS and 43 after mastectomy) being available and willing to undergo further cosmetic assessment. One patient had a complete response after PRT/PCRT and refused surgery. PRT/PCRT consisted of external beam radiation therapy (EBRT) with 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with a consecutive electron boost or (in case of BCS) a 10-Gy interstitial brachytherapy boost with Ir-192 prior to EBRT. Overall, chemotherapy was administered either prior to RT or concomitantly in the majority of patients. BCS and mastectomy were performed with and without reconstruction. The cosmetic outcome was assessed by patient questionnaire, panel evaluation, and breast retraction assessment (BRA) score. Results: Eighty percent of all BCS patients rated their overall cosmetic result as “excellent” or “good” as compared to 55.8% after mastectomy. Patient and panel ratings on cosmetic outcomes were similar between the two groups. No grade III or IV fibrosis were detected in any of the groups. The median BRA score after breast conserving surgery was 2.9. Conclusion: PRT/PCRT is associated with low grades of fibrosis and a good to excellent long-term cosmetic outcome.
AB - Background: Preoperative radiotherapy and chemoradiotherapy (PRT/PCRT) represent an increasingly used clinical strategy in different tumor sites. We have previously reported on a PRT/PRCT protocol in patients with locally advanced non-inflammatory breast cancer (LABC) with promising clinical results. However, concerns regarding a possible unfavorable influence on cosmesis still exist. Thus, the aim of the current study was to examine long-term cosmetic outcome in our series of LABC patients treated with PRT/PCRT followed by breast-conserving surgery (BCS) or mastectomy (ME). Patients and methods: Of the 315 patients treated with PRT/PCRT in the years 1991 to 1999, 203 were still alive at long-term follow-up of mean 17.7 years (range 14–21). Thirty-seven patients were lost to follow-up and 58 patients refused to be contacted, which resulted in 107 patients (64 patients after BCS and 43 after mastectomy) being available and willing to undergo further cosmetic assessment. One patient had a complete response after PRT/PCRT and refused surgery. PRT/PCRT consisted of external beam radiation therapy (EBRT) with 50 Gy (5 × 2 Gy/week) to the breast and the supra-/infraclavicular lymph nodes combined with a consecutive electron boost or (in case of BCS) a 10-Gy interstitial brachytherapy boost with Ir-192 prior to EBRT. Overall, chemotherapy was administered either prior to RT or concomitantly in the majority of patients. BCS and mastectomy were performed with and without reconstruction. The cosmetic outcome was assessed by patient questionnaire, panel evaluation, and breast retraction assessment (BRA) score. Results: Eighty percent of all BCS patients rated their overall cosmetic result as “excellent” or “good” as compared to 55.8% after mastectomy. Patient and panel ratings on cosmetic outcomes were similar between the two groups. No grade III or IV fibrosis were detected in any of the groups. The median BRA score after breast conserving surgery was 2.9. Conclusion: PRT/PCRT is associated with low grades of fibrosis and a good to excellent long-term cosmetic outcome.
KW - Breast conserving surgery
KW - Cosmesis
KW - Mastectomy
KW - Panel rating
KW - Patient rating
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U2 - 10.1007/s00066-019-01473-2
DO - 10.1007/s00066-019-01473-2
M3 - Article
C2 - 31101954
AN - SCOPUS:85066023116
SN - 0179-7158
VL - 195
SP - 615
EP - 628
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 7
ER -