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Cosmetic Outcomes With Irradiation in Stages 0 to II Breast Cancer

By: Lauren Harrison, MS
Posted: Tuesday, January 29, 2019

Hypofractionated whole-breast irradiation (HF-WBI) and conventional fractionated irradiation (CF-WBI) produced similar patient-reported cosmetic outcomes when followed by a tumor bed boost for early-stage breast cancer, according to a study published in the Journal of Clinical Oncology. Simona Shaitelman, MD, EdM, of The University of Texas MD Anderson Cancer Center, and colleagues assessed the safety of the hypofractionated therapy in patients with stages 0 to II breast cancer.

“Tumor bed boost, chemotherapy, and larger breast size do not seem to be strong contraindications to HF-WBI,” concluded the authors.

This multicenter phase III noninferiority trial recruited 287 women with stages 0 to II breast cancer who underwent margin-negative segmental mastectomy. Patients were randomly assigned to receive either HF-WBI with 42.56 Gy in 16 fractions plus 10 to 12.5 Gy in 4 to 5 fractions or CF-WBI with 50 Gy in 25 fractions plus 10 to 14 Gy in 5 to 7 fractions. Of the patients included in the study, 30% had received chemotherapy, and 36.9% had large breast size.

After a median of 4.1 years, the 3-year adverse cosmetic outcome rate was 5.4% lower with HF-WBI than with CF-WBI (8.2% vs. 13.6%). Patients undergoing chemotherapy saw a 4.1% higher adverse cosmetic outcome with HF-WBI. Those with large breasts saw an 18.6% lower adverse cosmetic outcome when treated with HF-WBI. A 3-physician panel assessed cosmesis of all patients and rated poor/fair outcomes in 28.8% of those treated with convention therapy and 35.4% of those treated with hypfractionated therapy. In addition, the 3-year local recurrence–free survival was 99% in both groups.

Disclosure: The study authors’ disclosure information may be found at ascopubs.org.



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