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Title: Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation

Abstract

Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment,more » HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.« less

Authors:
 [1];  [2]; ;  [3];  [4];  [1];  [5];  [1];  [6];  [3];  [7];  [1];  [7]
  1. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  2. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  3. Department of Biomedical Engineering, University of Texas, Austin, Texas (United States)
  4. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  5. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  6. Department of Engineering Technology, University of Houston, Houston, Texas (United States)
  7. (United States)
Publication Date:
OSTI Identifier:
22649877
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 97; Journal Issue: 5; Other Information: Copyright (c) 2016 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; GY RANGE 01-10; GY RANGE 10-100; IMAGES; IRRADIATION; MAMMARY GLANDS; NEOPLASMS; PHOTOGRAPHY; RADIOTHERAPY

Citation Formats

Reddy, Jay P., Lei, Xiudong, Huang, Sheng-Cheng, Nicklaus, Krista M., Fingeret, Michelle C., Shaitelman, Simona F., Hunt, Kelly K., Buchholz, Thomas A., Merchant, Fatima, Markey, Mia K., Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, Smith, Benjamin D., E-mail: bsmith3@mdanderson.org, and Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2016.12.021.
Reddy, Jay P., Lei, Xiudong, Huang, Sheng-Cheng, Nicklaus, Krista M., Fingeret, Michelle C., Shaitelman, Simona F., Hunt, Kelly K., Buchholz, Thomas A., Merchant, Fatima, Markey, Mia K., Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, Smith, Benjamin D., E-mail: bsmith3@mdanderson.org, & Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation. United States. doi:10.1016/J.IJROBP.2016.12.021.
Reddy, Jay P., Lei, Xiudong, Huang, Sheng-Cheng, Nicklaus, Krista M., Fingeret, Michelle C., Shaitelman, Simona F., Hunt, Kelly K., Buchholz, Thomas A., Merchant, Fatima, Markey, Mia K., Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, Smith, Benjamin D., E-mail: bsmith3@mdanderson.org, and Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Sat . "Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation". United States. doi:10.1016/J.IJROBP.2016.12.021.
@article{osti_22649877,
title = {Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation},
author = {Reddy, Jay P. and Lei, Xiudong and Huang, Sheng-Cheng and Nicklaus, Krista M. and Fingeret, Michelle C. and Shaitelman, Simona F. and Hunt, Kelly K. and Buchholz, Thomas A. and Merchant, Fatima and Markey, Mia K. and Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas and Smith, Benjamin D., E-mail: bsmith3@mdanderson.org and Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas},
abstractNote = {Purpose: To measure, by quantitative analysis of digital photographs, breast cosmetic outcome within the setting of a randomized trial of conventionally fractionated (CF) and hypofractionated (HF) whole-breast irradiation (WBI), to identify how quantitative cosmesis metrics were associated with patient- and physician-reported cosmesis and whether they differed by treatment arm. Methods and Materials: From 2011 to 2014, 287 women aged ≥40 with ductal carcinoma in situ or early invasive breast cancer were randomized to HF-WBI (42.56 Gy/16 fractions [fx] + 10-12.5 Gy/4-5 fx boost) or CF-WBI (50 Gy/25 fx + 10-14 Gy/5-7 fx). At 1 year after treatment we collected digital photographs, patient-reported cosmesis using the Breast Cancer Treatment and Outcomes Scale, and physician-reported cosmesis using the Radiation Therapy Oncology Group scale. Six quantitative measures of breast symmetry, labeled M1-M6, were calculated from anteroposterior digital photographs. For each measure, values closer to 1 imply greater symmetry, and values closer to 0 imply greater asymmetry. Associations between M1-M6 and patient- and physician-reported cosmesis and treatment arm were evaluated using the Kruskal-Wallis test. Results: Among 245 evaluable patients, patient-reported cosmesis was strongly associated with M1 (vertical symmetry measure) (P<.01). Physician-reported cosmesis was similarly correlated with M1 (P<.01) and also with M2 (vertical symmetry, P=.01) and M4 (horizontal symmetry, P=.03). At 1 year after treatment, HF-WBI resulted in better values of M2 (P=.02) and M3 (P<.01) than CF-WBI; treatment arm was not significantly associated with M1, M4, M5, or M6 (P≥.12). Conclusions: Quantitative assessment of breast photographs reveals similar to improved cosmetic outcome with HF-WBI compared with CF-WBI 1 year after treatment. Assessing cosmetic outcome using these measures could be useful for future comparative effectiveness studies and outcome reporting.},
doi = {10.1016/J.IJROBP.2016.12.021},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 97,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}