Long-term cosmetic outcome after preoperative radio-/chemotherapy in locally advanced breast cancer patients

Matuschek, Christiane; Nestle-Kraemling, Carolin; Haussmann, Jan; Bölke, Edwin; Wollandt, Sylvia; Speer, Vanessa; Njanang, Freddy Joel Djiepmo; Tamaskovics, Bálint; Gerber, Peter Arne; Orth, Klaus; Ruckhaeberle, Eugen; Fehm, Tanja; Corradini, Stefanie; Lammering, Guido; Mohrmann, Svjetlana; Audretsch, Werner; Roth, Stephan; Kammers, Kai; Budach, Wilfried

doi:10.1007/s00066-019-01473-2

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…No grade III or IV fibrosis were identified in any of these patient groups. The median breast retraction score after breast conserving surgery was 2.9 [58]. Further, quality of life (QoL) also seemed to not inferior to the general age-matched population [59].…”

Section: Neoadjuvant Radiochemotherapymentioning

confidence: 99%

“…The time sequence when to perform radiation therapy is still a question of debate and a large prospective multicenter trial in Germany will attempt to answer this question. Matuschek et al have shown in a single institute analysis that neoadjuvant radiochemotherapy for advanced breast cancer is a safe and reliable method of treating these patients [58]. They analyzed the cosmetic results of 315 patients with neoadjuvant radiochemotherapy in a long term follow up.…”

Section: Neoadjuvant Radiochemotherapymentioning

confidence: 99%

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Recent advances in radiotherapy of breast cancer

et al. 2020

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Radiation therapy is an integral part of the multidisciplinary management of breast cancer. Regional lymph node irradiation in younger trials seems to provide superior target coverage as well as a reduction in long-term toxicity resulting in a small benefit in the overall survival rate. For partial breast irradiation there are now two large trials available which support the role of partial breast irradiation in low risk breast cancer patients. Multiple randomized trials have established that a sequentially applied dose to the tumor bed improves local control with the cost of worse cosmetic results.

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Section: Neoadjuvant Radiochemotherapymentioning

confidence: 99%

Section: Neoadjuvant Radiochemotherapymentioning

confidence: 99%

Recent advances in radiotherapy of breast cancer

et al. 2020

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“…Our study is paralleled by a number of studies, 11,16 including some ongoing clinical studies, which lent support to the fact that preoperative therapies are potent in improving responses of breast cancer treatments 11‐15 . Conventionally, particularly for early‐staged localized breast cancer, chemotherapy, and radiation therapy are used postoperatively to reduce recurrence and cancer‐related mortality.…”

Section: Discussionmentioning

confidence: 62%

“…Therefore, systemic radiochemotherapy prior to surgery will also be an effective means to treat breast cancer. Despite a number of studies showing the benefit of preoperative therapies, 11‐15 it is still unclear whether the sequence of chemotherapy and radiotherapy will affect the clinical outcome of LABC treatment. Such information would be of significant importance to further enhance both the survival and breast conservation of LABC patients in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

XiChi

Zhou

et al. 2020

Breast J

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Background The study aims to perform a clinical trial to evaluate the effect of sequencing of systemic therapy on locally advanced breast cancer (LABC). Methods LABC patients (n = 733) underwent the combination of external beam radiation therapy, chemotherapy, and breast‐conservation surgery with difference sequences. Biopsy followed by histopathological examinations was used to assess treatment responses. The primary end point is ipsilateral local recurrence or death. The secondary end points include the incidence and severity of acute and late side effects, cosmesis, and cumulative incidence of regional recurrence and distant metastasis, and survival. The effects of sequence of therapies on the side effects and treatment outcomes were compared. Results Patients with preoperative systemic treatment, that is, chemotherapy and radiotherapy performed ahead of surgery, had less fibrosis and pain, and showed higher satisfaction regarding the breast conservation. Preoperative systemic treatment also led to better survival of the patients. Conclusions Preoperative systemic therapy is beneficial to alleviate side effects and improve the breast conservation, treatment outcome, and survival of LABC patients.

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“…[8,9] Most studies used clinical assessments, standardized questionnaires or standardized photographs to assess cosmetic outcome and adverse effects of breast RT. [10,11] Nevertheless, it remains difficult to objectively assess side effects, like erythema, edema or fibrosis, which can negatively influence the shape, symmetry and appearance of the breast, and subsequently the patient's quality of life.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional surface imaging in breast cancer: a new tool for clinical studies?

Koban

Etzel

et al. 2020

Radiat Oncol

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Background: Three-dimensional Surface Imaging (3DSI) is a well-established method to objectively monitor morphological changes in the female breast in the field of plastic surgery. In contrast, in radiation oncology we are still missing effective tools, which can objectively and reproducibly assess and document adverse events in breast cancer radiotherapy within the framework of clinical studies. The aim of the present study was to apply structuredlight technology as a non-invasive and objective approach for the documentation of cosmetic outcome and early effects of breast radiotherapy as a proof of principle. Methods: Weekly 3DSI images of patients receiving either conventionally fractionated radiation treatment (CF-RT) or hypofractionated radiation treatment (HF-RT) were acquired during the radiotherapy treatment and clinical follow-up. The portable Artec Eva scanner (Artec 3D Inc., Luxembourg) recorded 3D surface images for the analysis of breast volumes and changes in skin appearance. Statistical analysis compared the impact of the two different fractionation regimens and the differences between the treated and the contralateral healthy breast. Results: Overall, 38 patients and a total of 214 breast imaging sessions were analysed. Patients receiving CF-RT showed a significantly higher frequency of breast erythema compared to HF-RT (93.3% versus 34.8%, p = 0.003) during all observed imaging sessions. Moreover, we found a statistically significant (p < 0.05) volumetric increase of the treated breast of the entire cohort between baseline (379 ± 196 mL) and follow-up imaging at 3 months (437 ± 224 mL), as well as from week 3 of radiotherapy (391 ± 198 mL) to follow-up imaging. In both subgroups of patients undergoing either CF-RT or HF-RT, there was a statistically significant increase (p < 0.05) in breast volumes between baseline and 3 months follow-up. There were no statistically significant skin or volumetric changes of the untreated healthy breasts. Conclusions: This is the first study utilizing 3D structured-light technology as a non-invasive and objective approach for the documentation of patients receiving breast radiotherapy. 3DSI offers potential as a non-invasive tool to objectively and precisely monitor the female breast in a radiooncological setting, allowing clinicians to objectively distinguish outcomes of different therapy modalities.

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Long-term cosmetic outcome after preoperative radio-/chemotherapy in locally advanced breast cancer patients

Cited by 17 publications

References 34 publications

Recent advances in radiotherapy of breast cancer

Recent advances in radiotherapy of breast cancer

Effect of sequencing of preoperative systemic therapy on patients with locally advanced breast cancer

Three-dimensional surface imaging in breast cancer: a new tool for clinical studies?

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