Cosmetic analysis following breast-conserving surgery and adjuvant high-dose-rate interstitial brachytherapy for early-stage breast cancer: A prospective clinical study

Adam A. Garsa, Daniel J. Ferraro, Todd DeWees, Julie A. Margenthaler, Michael Naughton, Rebecca Aft, William E. Gillanders, Timothy Eberlein, Melissa A. Matesa, Imran Zoberi

Research output: Contribution to journalArticle

15 Citations (Scopus)

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 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.

Original languageEnglish (US)
Pages (from-to)965-970
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume85
Issue number4
DOIs
StatePublished - Mar 15 2013
Externally publishedYes

Fingerprint

Segmental Mastectomy
Brachytherapy
surgery
Cosmetics
breast
interstitials
Breast
cancer
Prospective Studies
Breast Neoplasms
dosage
infectious diseases
chemotherapy
pretreatment
Clinical Studies
Adjuvant Chemotherapy
Infection
physicians
radiation
predictions

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Cosmetic analysis following breast-conserving surgery and adjuvant high-dose-rate interstitial brachytherapy for early-stage breast cancer : A prospective clinical study. / Garsa, Adam A.; Ferraro, Daniel J.; DeWees, Todd; Margenthaler, Julie A.; Naughton, Michael; Aft, Rebecca; Gillanders, William E.; Eberlein, Timothy; Matesa, Melissa A.; Zoberi, Imran.

In: International Journal of Radiation Oncology Biology Physics, Vol. 85, No. 4, 15.03.2013, p. 965-970.

Research output: Contribution to journalArticle

Garsa, Adam A. ; Ferraro, Daniel J. ; DeWees, Todd ; Margenthaler, Julie A. ; Naughton, Michael ; Aft, Rebecca ; Gillanders, William E. ; Eberlein, Timothy ; Matesa, Melissa A. ; Zoberi, Imran. / Cosmetic analysis following breast-conserving surgery and adjuvant high-dose-rate interstitial brachytherapy for early-stage breast cancer : A prospective clinical study. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 85, No. 4. pp. 965-970.
@article{528dad8a902c47ec93cb06e860862c29,
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 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.",
author = "Garsa, {Adam A.} and Ferraro, {Daniel J.} and Todd DeWees and Margenthaler, {Julie A.} and Michael Naughton and Rebecca Aft and Gillanders, {William E.} and Timothy Eberlein and Matesa, {Melissa A.} and Imran Zoberi",
year = "2013",
month = "3",
day = "15",
doi = "10.1016/j.ijrobp.2012.08.027",
language = "English (US)",
volume = "85",
pages = "965--970",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Cosmetic analysis following breast-conserving surgery and adjuvant high-dose-rate interstitial brachytherapy for early-stage breast cancer

T2 - A prospective clinical study

AU - Garsa, Adam A.

AU - Ferraro, Daniel J.

AU - DeWees, Todd

AU - Margenthaler, Julie A.

AU - Naughton, Michael

AU - Aft, Rebecca

AU - Gillanders, William E.

AU - Eberlein, Timothy

AU - Matesa, Melissa A.

AU - Zoberi, Imran

PY - 2013/3/15

Y1 - 2013/3/15

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84875221140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84875221140&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2012.08.027

DO - 10.1016/j.ijrobp.2012.08.027

M3 - Article

C2 - 23058060

AN - SCOPUS:84875221140

VL - 85

SP - 965

EP - 970

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 4

ER -