Cosmetic outcomes of hypofractionated partial breast irradiation in early breast cancer

Abstract

Author(s): Arun Thimmarayappa, Karthik Srevatsa, Uday Krishna AS, Lokesh V, Varathraj C

Introduction: Breast conservative surgery is the standard of care in early breast cancer. Although, conventional fractionation whole breast irradiation followed by cavity boost is the current standard of practice; limiting the volumes to the cavity alone with additional margins with hypofractionation has yielded comparable results with local control. However, question of late toxicities is not addressed. The objective of the study was to evaluate and assess the late toxicities and cosmetic outcome of hypofractionated partial breast irradiation in early breast cancer. Patients and Methods: Twenty histologically proven early breast cancer patients underwent breast conservation surgery with sentinel lymph node biopsy. They received adjuvant radiation of 40Gy in 15fraction via 3-dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) technique. Post radiotherapy they were followed up for assessment of late toxicities – breast cosmesis – reported by patient and radiation oncologist. Results: At the end of three years 70% of the patients had excellent cosmesis. There was no difference between the radiation oncologist and patient assessment of cosmesis. Patients with resected specimen of < 220cc, breast separation of ≤21cm had better cosmesis (p=0.024) and with whole breast V20%(8Gy) ≤474.582cc had better cosmesis(p=0.05). Conclusion: Hypofractionated PBI without acceleration is a safe alternative for WBI preserving the cosmesis of the irradiated breast.

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Editors List

  • Osamu Tanaka

    Osamu Tanaka
    Assistant Professor,
    Department of Radiation Oncology
    Asahi University Hospital
    Gifu city, Gifu, Japan

  • Maher Abdel Fattah Al-Shayeb

    Department of Surgical Sciences, Ajman University, UAE

  • Andrzej Zdziennicki

    Institute of Gynecology and Obstetrics, Medical University of Lodz, I Clinic of Gynecology and Gynecological Oncology (Lodz, Poland)

  • Krzysztof Urbanski

    Head of the Oncology Gynecology Clinic, Oncology Center - Instytut im. Maria Sklodowska Curie, Department in Krakow (Krakow, Poland)

  • Andrzej Szawlowski

    Klinika Nowotworow Gornego Odcinka Uklad Digestii, Oncology Center - Institute (Warsaw, Poland)