Abstract
Purpose
Accelerated partial breast irradiation (APBI) and whole breast irradiation (WBI) are treatment options for early-stage breast cancer. The purpose of this study was to compare patient-reported-outcomes (PRO) between patients receiving multi-channel intra-cavitary brachytherapy APBI or WBI.
Methods
Between 2012 and 2015, 131 patients with ductal carcinoma in situ (DCIS) or early stage invasive breast cancer were treated with adjuvant APBI (64) or WBI (67) and participated in a PRO questionnaire. The linear analog scale assessment (LASA), harvard breast cosmesis scale (HBCS), PRO-common terminology criteria for adverse events- PRO (PRO-CTCAE), and breast cancer treatment outcome scale (BCTOS) were used to assess quality of life (QoL), pain, fatigue, aesthetic and functional status, and breast cosmesis. Comparisons of PROs were performed using t-tests, Wilcoxon rank-sum, Chi square, Fisher exact test, and regression methods.
Results
Median follow-up from completion of radiotherapy and questionnaire completion was 13.3 months. There was no significant difference in QoL, pain, or fatigue severity, as assessed by the LASA, between treatment groups (p > 0.05). No factors were found to be predictive of overall QoL on regression analysis. BCTOS health-related QoL scores were similar between treatment groups (p = 0.52).The majority of APBI and WBI patients reported excellent/good breast cosmesis, 88.5% versus 93.7% (p = 0.37). Skin color change (p = 0.011) and breast elevation (p = 0.01) relative to baseline were more common in the group receiving WBI.
Conclusions
APBI and WBI were both associated with favorable patient-reported outcomes in early follow-up. APBI resulted in a lesser degree of patient-reported skin color change and breast elevation relative to baseline.
Abbreviations
- APBI:
-
Accelerated partial breast irradiation
- WBI:
-
Whole breast irradiation
- PRO:
-
Patient-reported outcomes
- DCIS:
-
Ductal carcinoma in situ
- LASA:
-
Linear analog scale assessment
- HBCS:
-
Harvard breast cosmesis scale
- PRO-CTCAE:
-
Patient-reported outcomes version of the common terminology criteria for adverse events
- BCTOS:
-
Breast cancer treatment outcome scale
- QoL:
-
Quality of life
- BCT:
-
Breast conserving therapy
- IMRT:
-
Intensity modulated radiation therapy
- ER:
-
Estrogen receptor
- CT:
-
Computed tomography
- PTV:
-
Planning target volume
- HDR:
-
High-dose rate
- CTV:
-
Clinical target volume
- IRB:
-
Institutional review board
- HR-QoL:
-
Health-related quality of life
- IQR:
-
Interquartile range
- GEC-ESTRO:
-
Groupe européen de curiethérapie of european society for radiotherapy and oncology
- NSABP:
-
National surgical adjuvant breast and bowel project
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Funding
This project was supported by the Mayo Clinic CTSA through Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH).
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Krishan R. Jethwa, MD, Mohamed M. Kahila, MBBCh, Sean S. Park, MD, PhD, Robert W. Mutter, MD these are authors contributed equally.
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Jethwa, K.R., Kahila, M.M., Mara, K.C. et al. Patient-reported outcomes of catheter-based accelerated partial breast brachytherapy and whole breast irradiation, a single institution experience. Breast Cancer Res Treat 169, 189–196 (2018). https://doi.org/10.1007/s10549-018-4665-6
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DOI: https://doi.org/10.1007/s10549-018-4665-6