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Title: Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment

Abstract

Purpose: Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate 'excellent' or 'good' cosmesis in >90% of patients treated with BCT. Methods and Materials: Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval. Results: Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. 'Excellent' cosmesis was reported by 27% (n = 88), 'Good' by 44% (n = 144), 'Fair' by 24% (n = 81), and 'Poor' by 5% (n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changesmore » (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%). Conclusions: This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be 'excellent' or 'good' than would be expected, with 30% of BCT survivors reporting 'fair' or 'poor' cosmesis. Patient reported incidence of chronic pain, as well as cognitive and sexual changes, also appears higher than expected.« less

Authors:
 [1]; ; ;  [2];  [1]
  1. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
  2. Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania (United States)
Publication Date:
OSTI Identifier:
22058882
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 83; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DIAGNOSIS; MAMMARY GLANDS; NEOPLASMS; OSTEOPOROSIS; PAIN; PATIENTS; SKIN; TETRAGONAL LATTICES

Citation Formats

Hill-Kayser, Christine E., E-mail: hill@uphs.upenn.edu, Vachani, Carolyn, Hampshire, Margaret K., Di Lullo, Gloria A., and Metz, James M. Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.08.013.
Hill-Kayser, Christine E., E-mail: hill@uphs.upenn.edu, Vachani, Carolyn, Hampshire, Margaret K., Di Lullo, Gloria A., & Metz, James M. Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment. United States. doi:10.1016/J.IJROBP.2011.08.013.
Hill-Kayser, Christine E., E-mail: hill@uphs.upenn.edu, Vachani, Carolyn, Hampshire, Margaret K., Di Lullo, Gloria A., and Metz, James M. Sun . "Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment". United States. doi:10.1016/J.IJROBP.2011.08.013.
@article{osti_22058882,
title = {Cosmetic Outcomes and Complications Reported by Patients Having Undergone Breast-Conserving Treatment},
author = {Hill-Kayser, Christine E., E-mail: hill@uphs.upenn.edu and Vachani, Carolyn and Hampshire, Margaret K. and Di Lullo, Gloria A. and Metz, James M.},
abstractNote = {Purpose: Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate 'excellent' or 'good' cosmesis in >90% of patients treated with BCT. Methods and Materials: Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval. Results: Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. 'Excellent' cosmesis was reported by 27% (n = 88), 'Good' by 44% (n = 144), 'Fair' by 24% (n = 81), and 'Poor' by 5% (n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changes (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%). Conclusions: This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be 'excellent' or 'good' than would be expected, with 30% of BCT survivors reporting 'fair' or 'poor' cosmesis. Patient reported incidence of chronic pain, as well as cognitive and sexual changes, also appears higher than expected.},
doi = {10.1016/J.IJROBP.2011.08.013},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 83,
place = {United States},
year = {Sun Jul 01 00:00:00 EDT 2012},
month = {Sun Jul 01 00:00:00 EDT 2012}
}