Comparison of Mammographic Changes Across Three Different Fractionation Schedules for Early-Stage Breast Cancer

Abstract

Purpose As the use of hypofractionated breast radiation therapy (RT) increases, so will the need for long-term data on post-RT mammographic changes. The purpose of the present study was to longitudinally compare the incidence of common mammographic sequelae seen after breast conserving surgery and RT in patients treated with accelerated partial breast irradiation (APBI), hypofractionated whole breast irradiation (HWBI), and conventionally fractionated whole breast irradiation (WBI). Methods and Materials Patients treated with either APBI or HWBI after breast conserving therapy and with ≥3 mammograms of the treated breast were identified. They were matched 1:1 by age ±5 years to patients treated with WBI. The mammograms were evaluated for common post-RT breast findings by a mammographer who was unaware of the treatment. The outcomes were analyzed using a cumulative logistic regression model; P<.05 indicated statistically significance. Results Of 89 patients treated with RT from 2006 to 2011, 29 had received APBI, 30 had received HWBI, and 30 had received WBI. Their median age was 60 years (range 33–83). A total of 605 mammograms were evaluated, with a median follow-up of 48 months. The treatment technique did not affect the severity of architectural distortion when the groups were evaluated longitudinally. The likelihood of finding skin thickening decreased with increasing follow-up duration (odds ratio 0.6; P<.001) adjusted for fractionation schemes. No differences were seen with respect to changes in skin thickening, fluid collections, or calcifications among the treatment groups, after adjustment for the follow-up time. The clinical characteristics, including age, race, T stage, and chemotherapy use, were not linked to the likelihood of finding several mammographic phenomena over time. Conclusions Although specific post-treatment imaging findings evolved over time, RT fractionation did not alter the relative incidence or severity of architectural distortion, skin thickening, fluid collections, or calcifications. These findings will be useful to both radiologists and radiation oncologists when counseling patients regarding follow-up studies after RT.

Extended Hypofractionated Cancer Radiation Therapy Against Aged and Non-aged Breast Carcinomas Patients

“…Nonetheless, none of the poisonous impacts observed in case of lady patients whom were got sped up, hypo fractionated radio therapy as contrasted and the individuals who got the standard routine. Albeit more established age and enormous tumor size were related with a more awful restorative result, the results of the hypofractionated routine were like those of the standard routine [82], [31], [36], [40].…”

“…The assessment was supported by the overview driving body of partaking spot, and all patients gave taught consent form. Every maker going for data arrangement, data collection, and analysis of the examination [39], [40].…”

Fixed and random effect selections in generalized linear mixed models

“…Then this study longitudinally followed up the mammographic changes in early-stage breast cancer patients after BCT, and is interested in identifying covariates associated with the incidence or changes of common mammographic sequelae. 44 Data from 89 patients with a total of 605 longitudinally measured observations were included in the data analysis. Among several image parameters, we fitted a random effects logistic regression model with calcification (yes vs. no) as the dependent variable, and applied the proposed CD-S method to select fixed effects from the following covariates: age (years), years from radiation therapy, African Americans (yes vs. no), Her2/neu positive (yes vs. no), adjuvant chemo and/or hormonal therapy (yes vs. no), smoking (yes vs. no), bilateral disease (yes vs. no) and 2 unrelated and randomly generated standard normal noise variables.…”

“…Then this study longitudinally followed up the mammographic changes in early-stage breast cancer patients after BCT, and is interested in identifying covariates associated with the incidence or changes of common mammographic sequelae. 44…”

Time to development and imaging features of new calcifications in the treated breast after breast‐conserving therapy

“…Breast-conserving therapy (BCT), lumpectomy followed by radiation treatment, has been generally recognized as the treatment of choice for small and early-stage breast cancers [1][2][3] . However, women who undergo BCT are at risk for residual and locally recurrent disease.…”