Is breast seroma after tumour resection associated with patient-reported breast appearance change following radiotherapy? Results from the IMPORT HIGH (CRUK/06/003) trial

Bhattacharya, Indrani; Haviland, J.S.; Perotti, C.; Eaton, D.; Gulliford, S.; Harris, Emma; Coles, Charlotte E.; Kirwan, Cliona C.; Bliss, Judith; Kirby, Anna M.; Trialists, Import

doi:10.1016/j.radonc.2019.03.022

Cited by 8 publications

(3 citation statements)

References 21 publications

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“…Acute toxicity of H‐SIB was mild 24‐27 and slightly lower than in HF with sequential boost (H‐SEQ), 28 C‐SIB 27,29,30 or CF with sequential boost (C‐SEQ) 26,30 . Two prospective randomized trials comparing H‐SIB vs C‐SEQ or H‐SEQ remain unpublished 31,32 . In the current study, good/excellent cosmesis was rated by 87.7% and 73.6% of patients in H‐SIB and C‐SIB, respectively, which was consistent with 82%‐100% and 73.6%‐96.5% in other studies 11,12,15,19‐23,31,33‐35 .…”

Section: Discussionsupporting

confidence: 80%

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Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

et al. 2020

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To compare patient‐rated cosmetic and satisfactory outcomes between conventional fractionation with simultaneously integrated boost (C‐SIB) vs hypofractionation with SIB (H‐SIB) in early breast cancer. Patients with stage I and II breast cancer who received breast‐conserving surgery followed by radiation with SIB to tumor bed and completed questionnaire were included in this study. Radiotherapy was as follows: C‐SIB arm = 50 Gy and 65 Gy in 25 fractions and H‐SIB arm = 43.2 Gy and 52.8 Gy in 16 fractions to the whole breast and tumor bed, respectively. Single cross‐sectional assessment of the breast cosmesis was done by patients and radiation oncologist at a follow‐up visit. Breast cosmetic and satisfaction scores were collected using a four‐point Harvard/NSABP/RTOG cosmesis criteria scale and a four‐point Likert‐type scale, respectively. Of a total of 114 patients (C‐SIB = 57) and (H‐SIB = 57) arms, a median time from radiotherapy completion to questionnaire response was 7.2 years. Patient‐rated cosmetic outcome in C‐SIB vs H‐SIB was “excellent” in 40.3% vs 45.6%, “good” in 33.3% vs 42.1%, “fair” in 21.1% vs 10.5%, and “poor” in 5.3% vs 1.8% (P = .288). Corresponding satisfaction was “very satisfied” in 52.6% vs 57.9%, “satisfied” in 40.4% vs 35.1%, “neutral” in 7.0% vs 5.2%, and “unsatisfied” in 0% vs 1.8% (P = .683). Stage I and older age at radiotherapy were predictors for favorable (good or excellent) cosmesis and satisfaction, respectively. In early‐stage breast cancer, H‐SIB provided a trend for better cosmesis than C‐SIB while maintaining satisfaction. The reduction in treatment duration and cost as well as favorable cosmesis outcomes encourages the use of H‐SIB.

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Section: Discussionsupporting

confidence: 80%

“…A high tumor‐to‐breast ratio is the most important factor affecting cosmesis 3,15,24,32 . Small tumor size and large breast volume were associated with better cosmesis when used HF with intraoperative RT 37 .…”

Section: Discussionmentioning

confidence: 99%

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

et al. 2020

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“…The seroma may have influenced older trials in the uncorrected defect following more extensive surgical excisions (tumour + >5mm margins). However, recent reports show it to be less of an issue, possibly due to resolution by the time of RT in a patient undergoing adjuvant chemotherapy [41].…”

Section: Discussionmentioning

confidence: 99%

Use of tumour bed boost radiotherapy in volume replacement oncoplastic breast surgery: A systematic review

Garreffa

Meattini

Coles

et al. 2023

Critical Reviews in Oncology/Hematology

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Fractionation Approaches in Whole Breast RT

Freedman

2023

Curr Breast Cancer Rep

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Is breast seroma after tumour resection associated with patient-reported breast appearance change following radiotherapy? Results from the IMPORT HIGH (CRUK/06/003) trial

Abstract: Highlights Seroma was not associated with patient-reported breast appearance change after breast radiotherapy. Haematoma and smoking were significant risk factors for patient-reported breast appearance change. Seroma prevalence in our study was lower than previous reports.

Cited by 8 publications

References 21 publications

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

Long‐term patient‐rated cosmetic and satisfactory outcomes of early breast cancer treated with conventional versus hypofractionated breast irradiation with simultaneous integrated boost technique

Use of tumour bed boost radiotherapy in volume replacement oncoplastic breast surgery: A systematic review

Fractionation Approaches in Whole Breast RT

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