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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Wednesday, May 8, 2024
With longer survival after breast cancer treatment come late treatment-related adverse effects, and their impact on patients’ quality of life is a concern. During the European Society for Radiotherapy and Oncology (ESTRO) 2024 Annual Congress (Abstract 245), Remi A. Nout, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, and colleagues presented a preliminary analysis of the development of breast fibrosis occurring as a late adverse event in patients who have had breast-conserving therapy followed by radiation therapy. Specifically, using data from the ongoing STARLINGS study, they studied the relationships among the presence and severity of fibrosis, cosmetic outcome, and quality of life.
Breast fibrosis may lead to pain, breast retraction, and breast asymmetry, and it occurs as a late adverse event in 10% to 30% of patients. And for 2% to 5%, it may be severe.
A total of 326 patients treated with breast-conserving therapy between 2016 and 2020 were evaluated for fibrosis in one outpatient visit between 2 and 6 years after treatment. They were divided into two groups based on fibrosis severity: group 1 (245 patients; fibrosis grade 0 [none] to 1 [mild]) and group 2 (81 patients; fibrosis grade 2 [moderate] to 3 [severe]). Of them, 296 patients returned their quality-of-life Breast-Q questionnaires. “Most patients were treated with simple oncoplastic techniques: 195 (79.6%) in group 1 vs 63 (77.8%) in group 2,” Dr. Nout and co-investigators reported.
The group 2 patients scored worse than the group 1 patients on cosmetic outcome, and they reported lower quality of life on psychosocial, physical well-being, breast satisfaction, and adverse effects of radiation domains. Further, there were “significant negative associations between psychosocial well-being and relative Breast Overlap Difference, and [between] satisfaction with breasts and relative Breast Retraction Assessment, relative Lower Breast Contour, and relative Breast Overlap Difference (P < .001).” These results highlight the importance of reducing the risk of fibrosis development, the authors emphasized.
Disclosure: No disclosure information was provided.
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