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Title: Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study

Abstract

Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRAmore » over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.« less

Authors:
; ;  [1];  [2];  [3];  [2];  [4]; ;  [2];  [1];  [1]
  1. Department of Radiation Oncology, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)
  2. Department of Surgery, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)
  3. Department of Medicine, Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri (United States)
  4. (United States)
Publication Date:
OSTI Identifier:
22420299
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 85; Journal Issue: 4; Other Information: Copyright (c) 2013 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; BRACHYTHERAPY; CHEMOTHERAPY; CLINICAL TRIALS; COMPARATIVE EVALUATIONS; DOSE RATES; MAMMARY GLANDS; MEDICAL PERSONNEL; NEOPLASMS; PATIENTS; SURGERY; WOMEN

Citation Formats

Garsa, Adam A., Ferraro, Daniel J., DeWees, Todd, Margenthaler, Julie A., Naughton, Michael, Aft, Rebecca, Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri, Gillanders, William E., Eberlein, Timothy, Matesa, Melissa A., and Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2012.08.027.
Garsa, Adam A., Ferraro, Daniel J., DeWees, Todd, Margenthaler, Julie A., Naughton, Michael, Aft, Rebecca, Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri, Gillanders, William E., Eberlein, Timothy, Matesa, Melissa A., & Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu. Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study. United States. doi:10.1016/J.IJROBP.2012.08.027.
Garsa, Adam A., Ferraro, Daniel J., DeWees, Todd, Margenthaler, Julie A., Naughton, Michael, Aft, Rebecca, Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri, Gillanders, William E., Eberlein, Timothy, Matesa, Melissa A., and Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu. Fri . "Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study". United States. doi:10.1016/J.IJROBP.2012.08.027.
@article{osti_22420299,
title = {Cosmetic Analysis Following Breast-Conserving Surgery and Adjuvant High-Dose-Rate Interstitial Brachytherapy for Early-Stage Breast Cancer: A Prospective Clinical Study},
author = {Garsa, Adam A. and Ferraro, Daniel J. and DeWees, Todd and Margenthaler, Julie A. and Naughton, Michael and Aft, Rebecca and Department of Surgery, John Cochran Veterans Hospital, St. Louis, Missouri and Gillanders, William E. and Eberlein, Timothy and Matesa, Melissa A. and Zoberi, Imran, E-mail: izoberi@radonc.wustl.edu},
abstractNote = {Purpose: To prospectively evaluate cosmetic outcomes in women treated with accelerated partial breast irradiation using high-dose-rate interstitial brachytherapy for early-stage breast cancer. Methods and Materials: Between 2004 and 2008, 151 patients with early-stage breast cancer were enrolled in a phase 2 prospective clinical trial. Eligible patients had stage Tis-T2 tumors of ≤3 cm that were excised with negative margins and with no nodal involvement. Patients received 3.4 Gy twice daily to a total dose of 34 Gy. Both the patients and the treating radiation oncologist qualitatively rated cosmesis as excellent, good, fair, or poor over time and ascribed a cause for changes in cosmesis. Cosmetic outcome was evaluated quantitatively by percentage of breast retraction assessment (pBRA). Patients also reported their satisfaction with treatment over time. Results: Median follow-up was 55 months. The rates of excellent-to-good cosmesis reported by patients and the treating radiation oncologist were 92% and 97% pretreatment, 91% and 97% at 3 to 4 months' follow-up, 87% and 94% at 2 years, and 92% and 94% at 3 years, respectively. Breast infection and adjuvant chemotherapy were independent predictors of a fair-to-poor cosmetic outcome at 3 years. Compared to pretreatment pBRA (7.35), there was no significant change in pBRA over time. The volume receiving more than 150 Gy (V150) was the only significant predictor of pBRA. The majority of patients (86.6%) were completely satisfied with their treatment. Conclusions: Patients and the treating physician reported a high rate of excellent-to-good cosmetic outcomes at all follow-up time points. Acute breast infection and chemotherapy were associated with worse cosmetic outcomes. Multicatheter interstitial brachytherapy does not significantly change breast size as measured by pBRA.},
doi = {10.1016/J.IJROBP.2012.08.027},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 4,
volume = 85,
place = {United States},
year = {Fri Mar 15 00:00:00 EDT 2013},
month = {Fri Mar 15 00:00:00 EDT 2013}
}